Alcoholic Inebriety: 



FROM 



A MEDICAL STANDPOINT. 



WITH 



CASES FROM CLINICAL RECORDS. 



BY . 

JOSEPH PAKRISH, M.D. 




PHILADELPHIA: 

P. BLAKISTON, SON & CO., 

1012 Walnut Street. 
1883. 






Entered according to Act of Congress, in the year 1883, by 

P. BLAKISTON, SON & CO., 

In the Office of the Librarian of Congress, at Washington, D. C. 



TO THE MEMORY OF 

DONALD DALRYMPLE, M.P., M.D., J.P., 

D.L. for the County of Norfolk, 

F.R.G.S., 

as a token of the high personal esteem in which he 

was held in the 

United States of America, 

and in remembrance also of his distinguished 

services as chairman of the 

Select Committee of the House of Commons 

on 

Habitual Drunkards, 

THIS VOLUME IS RESPECTFULLY DEDICATED 
BY THE AUTHOR. 



PEEFACE. 



I have written the following pages with a few leading and guid- 
ing thoughts constantly before me, which I may present in the 
following form : — 

From the ordinary and popular outlook, inebriety corrupts a wide 
range of both public and private morals, and is so interwoven with 
the affairs of life, both domestic and civil, that it is looked upon as 
the chief factor of crime, of insanity and many other diseases, and 
as a general disturber of all that should be cherished as valuable in 
the life of individuals and of the community. 

Efforts have been put forth to arrest its progress, if not to apply 
a radical remedy for its evils, to which the pulpit, the press, the 
platform and the ballot, have all contributed a share of influence, 
till the land is covered with organizations having for their standard 
the doctrine of abstinence and prohibition. 

Taking half a century ago as a starting point, the growth of the 
temperance sentiment of the country has been marvelous, and to- 
day, simply as a sentiment, it holds a prominent and commanding 
position ; and yet we are confronted with the discouraging state- 
ment, that dram-drinking and drunkenness are on the increase. 

From another outlook, not so popular, because not so familiar, 
another view may be had, which, though more limited in its scope, 
is none the less important, because it reveals the causal beginnings 
from which flow the results that are recognized as intoxication. 

As yet, this new field has not been explored as it might have 
been, and as the gravity of the subject demands, notwithstanding 
it discloses the remote causes of inebriety, and indicates, the 
remedial course to be followed in dealing with it. 

This is doubtless partly due to the fact that the new line of 
research is, in a degree, technical and scientific, and the people 
are not disposed to go behind what they see in the inebriate and 

V 



VI PREFACE. 

his surroundings, to attempt to penetrate tissues, and search after 
forces with which they are not familiar. 

It has been my purpose, therefore, in the following pages, to 
state principles and facts, and enforce them, so far as I could, from 
the material in my possession, by cases — all of which have either 
been under my own care, or within my knowledge. 

That physicians may be induced to take a deeper interest in this 
subject, if examined from their own standpoint, is a hope which 
has stimulated my endeavor to present the aspect of disease, espe- 
cially as it is fortified by the testimony of some of the most eminent 
men of the profession. 

Those physicians who are specially interested in nervous dis- 
eases, and whose attention to morbid psychology has enabled them 
to contribute freely to advance the science of psychiatry, may find 
abundant aids to their researches by studying from their special 
standpoint the disease we are considering. 

Following these thoughts, I have allowed them to shape the plan 
of the book, which, though it might be improved as to arrange- 
ment, is nevertheless the vehicle for presenting what I regard as 
highly important truths. 

To the medical profession I would say that the sections on Trau- 
matic Inebriety, on the Trance State, and on the Relation between 
Insanity and Inebriety, discuss topics of increasing importance and 
interest, especially in a medico-legal sense, and should be freely 
investigated. 

THE AUTHOR. 

Burlington, New Jersey, April, 1883. 



CONTENTS. 



PAGE 

Who are Inebriates? 9 

The Vice Aspect 12 

The Crime View.. 24 

Inebriety a Disease 40 

Solitary, Midnight Inebriates 52 

Inebriates with Tendencies to Special Vices, and to 

Specific Forms of Violence 60 

Traumatic Inebriety 68 

Hereditary Inebriates 75 

Inebriety and Insanity— How Belated 88 

Asylums for Insane and for Inebriates. 

Insane Asylums 114 

Inebriate Asylums 121 

The Inebriates' View 130 

How to Deal with Inebriates 139 

Different Alcohols and Their Effects 158 

The Psychology of Inebriety 163 

Summary 180 

Index 183 



CASES TO BE FOUND IN THE TEXT 

ILLUSTRATIVE OF DIFFERENT FORMS OF INEBRIETY. 



UNDER "VICE ASPECT," page 

A Wayward Youth 14 

Alternately a Temperance Lecturer and Inmate of an Asylum. 17 
UNDER " THE CRIME YIEW." 

Trespass and Assault— Clerk 25 

Forgery — An Agent 26 

Manslaughter — A Prisoner 27 

UNDER THE HEAD OF "DISEASE." 

Ungovernable Craving — An Educator 42 

Psychical Intoxication — Father and Son 49 

Nervous Asthenia — A Clergyman , 52 

Solitary Night Walker — A Retired Gentleman 54 

.An Idiosyncrasy; Alcohol, Opium, Hasheesh — A Student 56 

Once a Year Drunk — A Successful Merchant, 61 

" Alcoholic Trance" — Ride with a Stolen Horse , 63 

" Alcoholic Trance " — A Gentleman Reveals Secrets 73 

Automatism — A Member of the Bar 73 

" Alcoholic Trance" — Stealing Horse and Carriage 74 

" Alcoholic Trance " — Unconscious Murder 74 

Mania from Sudden Abstinence — A Lawyer 97 

Dementia and Death from Sudden Abstinence — A Lawyer 98 

Insanity and Intoxication Interchangeable — A Huckster 99 

On Borderland of Insanity — A Woman 142 

(from Crothers). Intemperance Induced by Sunstroke — A 

Merchant , 144 

(from Crothers). Drunkenness and Death from Profound 

Grief — A Correct and Temperate Man 145 

(from Crothers). Intoxication and Dishonesty from Financial 

Disaster and Domestic Bereavement— A Wealthy Merchant. 145 

Debauch Prevented — A Physician , 147 

An Habitual Drunkard Wants a Chance — Keeper of Temper- 
ance Restaurant 152 

A Psychical State — A Young Man 166 



ALCOHOLIC INEBRIETY 



FROM A MEDICAL STANDPOINT. 



WHO ARE INEBRIATES? 

There are some persons who will never be drunkards, and others 
who will be so, in spite of all that can be done for them. Some 
are drunkards by choice, and some by necessity. — Macnish — 
Anatomy of Drunkenness. 

In the present state of knowledge, we have no need 
to retrace steps that have already been taken, to demon- 
strate the universal prevalence of a desire for artificial 
stimulation among all peoples, in every nation on the 
globe. It is sufficient to recognize the fact, that while 
there is a natural and necessary adaptation of our stand- 
ard foods to the normal demands of the human economy 
in a state of health, there is an equally apparent adapta- 
tion of the distinct and separate chemical qualities of such 
foods, to the various abnormal conditions which afflict 
humanity in the form of disease, or which disclose them- 
selves in that wide range of physical disturbances in which 
there is neither perfect health, nor localized disorder. 
This fact constitutes the basis of our materia medica, 
and is the starting point of the science of therapeutics. 
"Within this limitless range of morbid feelings, and 
undefined sensations, w r e lose sight of the border line 
2 9 



10 ALCOHOLIC INEBRIETY. 

between health and disease, and so far as the selection of 
remedies is concerned, the distinction between foods 
and medicines is also obliterated. What are recognized 
by all, as foods and medicines are employed interchange- 
ably in the treatment of the multitude of cases which 
are neither sick nor well. It is among such persons 
we must look for the consumers of alcoholic beverages, 
and such drugs as possess similar qualities. Whether 
such qualities are to be regarded as nutritive or medici- 
nal, depends of course, upon the degree of departure in 
each case from the typical standard of perfect health. 
Such persons are driven by their necessities, to explore 
the region of artificial, or more properly, unnatural 
nutrients, when they begin to realize a craving or lust 
to which they have hitherto been strangers. As the 
vital chemistry within them, fails to extract from natural 
and wholesome food, suitable nourishment for their 
enervated or perverted nerve structure, they search after 
such substances as the chemistry of science may evolve, 
from the fruits of the earth, that they may be composed, 
exhilarated or narcotized, in accordance with the con- 
cealed cravings within. 

Evenly balanced people, who are by nature, calm and 
self-possessed, and in good bodily health, are not those 
who usually fall into excess. With bodies in a normal 
state, and fed by natural food ; and minds well poised, 
deliberate and disciplined by culture, thus constituting 
a being self-controlled and vigorous, they have no need 
to venture into the realm of artificial nutrients, seeking 
for specifics to recuperate exhausted nerves, or to supple- 



WHO ARE INEBRIATES? 11 

merit ordinary diet. We must look for the chief factors 
of the craving for drinks among the ailing and half 
sick, who suffer from disquietude of nerve, dyspepsia, 
and the various hysteric and kindred phenomena, that 
are now so readily recognized, even by unprofessional 
observers. 

Thus we come naturally and logically to apprehend 
the remote causes of inebriety. That they are intrinsic 
and belong to the individual, is without doubt, true. 
This brings us also to the real issue that is involved in 
the subject we are considering. It is not a legal ques- 
tion, the issue being revenue, or no revenue. It is not 
simply a moral question, the issue being between the 
use, and non-use of intoxicants. It is a question of 
nerves — a neurosis — the issue being between soundness, 
and unsoundness of structure or function; between a 
complete and an incomplete manhood. It is disease, 
and in the language. of the " American Association for 
the Cure of Inebriates," "a disease that is curable in the 
same sense that other diseases are, its primary cause 
being a constitutional susceptibility to the alcoholic im- 
pression, which may be inherited or acquired." 

This disease, however, is not to be regarded as an 
entity that approaches and invades the human organism 
from without, but rather as a variation of natural func- 
tion, having its source in the system itself. It may be 
implanted somewhere in the complex structure which 
constitutes the man, by hereditary taint. It may be, by 
some obscure and undefined qualities coming together, 
which, by their active and retroactive processes, originate 



12 ALCOHOLIC INEBRIETY, 

and evolve symptoms that indicate a departure from a 
healthy standard. 

The existence of a predisposition to physical disease 
and to moral and mental qualities, to say nothing of 
resemblances of persons and manners, is a fact which is 
as familiar to the people, as any other fact in the natural 
history of the race. It constitutes a part of each family 
record, and belongs, as an entail, to the inheritance of 
every household. In its relation to the subject before 
us, no exception can be made. The law of heredity is 
inflexible, and its behests are without compromise. 

There are, however, aspects of the subject which are 
recognized by the popular verdict as vice and crime, 
that deserve a share of attention, before proceeding to 
discuss the subject in its aspect as disease. 

THE VICE ASPECT. 

By inebriety as a vice, is meant that form of it which 
is not characterized in the beginning, by any noticeable 
physical longing, or deep-seated appetite or craving, 
such as is experienced by those whose nerve centres are 
disturbed, either by external injury, or by latent func- 
tional impulse. It is a form of inebriety resulting 
primarily from a mental or emotional prompting to 
indulge in intoxicants. There are multitudes of persons 
who do not consult either conscience or judgment, but 
who are ready to tread any path that others may mark 
out for them, if it leads in the direction of bodily or 
mental pleasure. 

Such persons not unfrequently drift into evil prac- 



THE VICE ASPECT. 13 

tices, without seeming to be aware of the course they 
are pursuing. To them, the first " drunken fit " is an 
accident. Having once fallen, especially if the acces- 
sories of the debauch were at first pleasing, it is very 
easy to float down the same enticing current far enough 
to create and establish the very condition, that eventu- 
ates in the confirmed neurosis which constitutes the dis- 
ease. At first it is a vicious propensity, indulgence in 
which may terminate in disease or crime, or both. It 
has its counterpart in numerous other departures from 
the laws of health, which terminate sometimes in disease, 
and sometimes in criminal conduct, and the analogy 
between this disease and others, both as relates to 
causation, progress and results, cannot be maintained 
without the presentation of this view of the subject. 

A person may be so regardless of the laws of health 
as to indulge in a course of diet, which, though proper 
in moderation and at suitable intervals, may be injurious 
under opposite circumstances, finally creating disorder 
of the alimentary system, and resulting in chronic dis- 
ease. The primary act of inordinate use may be a mere 
vice, which leads on to repeated vicious indulgences, the 
outcome of which is a fixed pathological state. As 
applied to intoxicants, as well as to ordinary food, the 
term vice may be legitimately employed in its applica- 
tion to the primary acts, as justly as the term disease 
may be applied to the developed condition, that is recog- 
nized as pathological. 

It is somewhat difficult to determine the dividing 
line between vice and disease, and yet there is a certain 



14 ALCOHOLIC INEBRIETY. 

pathognomonic sign, which, if it has not been accurately 
described by others, is yet, I think, capable of delineation 
as marking the advent of a disordered state ; and that 
is, — a change of character. After repeated indulgences 
in the use of alcoholic liquors, so as to establish the 
habit, and a craving for its continuance is set up, the 
character becomes modified, and the phenomena of 
disease manifest themselves.* 

Dr. Forbes Winslow, of London, the late distinguished 
author and teacher, says : — 

" There is a normal drunkenness, as there are 
normal forms of any other vice. It is very difficult 
to deal with drunkenness as a vice, but when it 
passes the boundary, and ceases to be a vicious pro- 
pensity, then the morbid craving for stimulants is 
clearly traceable to the mental condition. * * * The 
boundary line may be drawn between the vice of gluttony 
and the diseases which may follow, in which visceral 
inflammation and deterioration take place, and various 
forms of organic disease are developed." 

The following case is offered in illustration : — 

No. 460. A. B., set. 30. A wayward, impulsive 
youth, with no regular employment. He lacks applica- 
tion and industry, and is fond of mirthful associates, and 

* My friend, Dr. T. D. Crothers, refers to this fact in several 
cases recorded in his pamphlet on " The Trance State in Ine- 
briety." A railroad conductor who drank moderately for two 
years, when "his disposition began to change." He became 
"more suspicious as he grew older," etc., "his mind exhibited 
evidenoe of failure in the irritability and changed disposition, 
etc." 



THE VICE ASPECT* 15 

ready for excitement of any description. A wide circle 
of acquaintances visit his father's house, and he is always 
ready to join them, at home or abroad, in any engagement 
that promises either mirth or sorrow. He was occasion- 
ally led into intoxication, which was generally, pleasur- 
able to him. Recovering from it, and being reproved 
by his family, he would naturally swing over to the 
other extreme, and it was quite common for him to be 
seized by paroxysms of religious fervor, when he would 
sign the pledge, attend religious meetings, and abstain 
for months at a time. He would pursue such a life 
under the leading of his mother and sisters, and then 
suddenly break away again, being at the time excited by 
an election, a fire, or something that caused a sudden 
deviation from his steady line of conduct. The deflec- 
tion once begun, originated a new course in the direction 
toward which it naturally led, till, enfeebled by its own 
persistency, it was readily exhausted, and another depar- 
ture from that course, created still another line of diver- 
gence, which, followed to its end, completed the zig-zag 
outline of his character. I have known him to watch 
by the sick, night after night, administer stimulants 
punctually, without tasting them himself, and perform 
all the offices of a nurse, with the tenderness and deli- 
cacy of a woman. On the occasion of a death, he would 
wash the cadaver, and apply himself, of choice, to need- 
less menial services, and after all was over, weep with 
the apparent grief of a brother, whether for the loss of 
a hospital companion, or for the loss of an opportunity 
to distinguish himself, I know not. In the absence of 



16 ALCOHOLIC INEBRIETY. 

such or similar occasions, when body and mind were 
fully occupied, I have known him debauched to the 
lowest degree, and afterward be as repentant and devout 
as before. His life was made up of self-sought, if not 
self-created tragic displays. His drunkenness was a 
mere incident, which took its turn with other vices, as 
occasion or opportunity might determine. Such men 
frequently return to a life of sobriety and uprightness, 
if, in the race between the worse and better qualities of 
their nature, the latter may maintain the ascendancy 
long enough to fix the habit, and give permanency to the 
inclination for a steady life. If, however, the deflec- 
tions from a normal line are toward the evil side of life 
more frequently, and for longer periods, than toward the 
virtuous and good, the evidences of disease become 
apparent. Among these may be named, irritability of 
temper, a spirit of exaction, a self-consciousness that is 
offensively exaggerated, a suspicion that is morbid, a 
degree of secrecy and falsehood, that was not previously 
exhibited, together with boastful and pretentious lan- 
guage; all of which may be grouped with similar symp- 
toms, as pathognomonic of disordered cerebral function. 
The man is changed. He is no longer a wayward youth, 
with character scarcely formed ; but he is a victim of 
disease, that is marked by positive symptoms, that fix 
his character, and establish him as an inebriate. 

Another case of like character has come under my 
notice, though not under my care, but it is so distinctly 
emotional in type, that I cannot forbear noticing it 
briefly : — 



THE VICE ASPECT. 17 

For several months of the year he is an inmate of an 
inebriate's ward of a public institution. Committed for 
drunkenness only, guilty of no crime, and creating no 
disturbance, but simply docketed as " drunk." During 
other months of the year, when religious revivals and 
temperance lectures are in order, he is actively engaged 
in good works. He is reported to be an efficient tem- 
perance advocate, and is sometimes employed as a public 
speaker in behalf of the cause. When intoxicated, he 
is lively and joyous, and a religious fervor of expression 
and devout performances simulating worship character- 
ize his debauchery. He is said to be free from other 
vices, and in the indulgence of the one, evinces no taste 
or tendency in the direction of profanity, lewdness, or 
any sort of crime. He will probably terminate his life 
in an asylum, though it may be that such a change may 
occur in his cerebral organism, as to give a wholesome 
direction to his tastes. 

Dr. Winslow attributes the morbid craving to a new 
mental condition, and, of course, the reverse is as true, 
that a cessation of the morbid craving, is due to an altered 
mental condition. A significant fact in connection with 
waste of brain substance is, that it is repaired, according 
to Carpenter, "by a complete reproduction of normal 
tissue." Now, if it be true that the condition of the 
brain that determines human conduct in any given di- 
rection, must be modified in order to produce a different 
line of conduct in an opposite direction, it is easily 
understood how, by the substitution of new tissue for 



18 ALCOHOLIC INEBRIETY. 

the old and wasted substance, a new direction may be 
given to the life and conduct of the individual. 

The tendency in nature being toward the maintenance 
of the perfect type, we may look for an endowment of 
new normal tissue where all the conditions are favorable, 
and under such circumstances a cure, or what is popu- 
larly called reformation, takes place. Around this 
single fact are clustered the opposing theories and state- 
ments which characterize the history of this subject. If 
the public mind could lay hold of, and appreciate the 
doctrine that a sound physiological basis is essential to 
a perfectly sound and evenly balanced moral nature, 
there would not be the degree of divergence between 
the real truth, and what is commonly accepted as truth, 
in this matter. In the most common forms of alimen- 
tary disorder it is not difficult for people to observe the 
altered morale to which reference has already been 
made, The boundary line between the vice of gluttony, 
and the diseases which follow it, in which there is 
visceral inflammation and deterioration, is readily dis- 
tinguished by the very same class of symptoms that 
designate the disease of inebriety. As the vice passes 
into a state of visceral derangement, which is disease, 
the change of character begins to manifest itself. Noth- 
ing is more common, than the irritable temper of 
dyspeptics, the gloomy moodiness that accompanies 
liver derangement, or the odd fancies, and vagaries of 
hysteria, which so commonly represent sympathy with 
diseased organs. The same law is applicable to the 
subject in hand, and no one who has observed closely, 



THE VICE ASPECT. 19 

can have failed to notice the differences of character 
which are exhibited in the career of an inebriate, as he 
progresses from the careless, motiveless beginning, to 
the stage of cerebral disorder. 

If there is one prevailing symptom which is common 
alike to all, it is an ever present and magnified con- 
sciousness of self. Such persons require attention, and 
exact it of others. They are self-important, and demand a 
recognition of their importance by others. Their symp- 
toms are exaggerated, and their sufferings intense, and 
unless this is appreciated by others as by themselves, they 
are provoked, and sometimes passionate. These symptoms 
do not appear, however, till the boundary line is passed. 

Reviewing the vice aspect of inebriety, there seems to 
be some ground upon which to rest the theory that it is 
not always disease, though Dr. T. D. Crothers, of 
Hartford, Conn., who has had ample opportunities for 
observation and study, writes to me as follows : — 

u Intemperance as a vice is not a clinical reality, and 
this term will be dropped when we know more about 
the subject. I think it is misleading, and could be 
applied with as much propriety to the first stages of 
paralysis, and to many cases of insanity, when the first 
symptoms are changes of character, morals, habits, etc. My 
view that inebriety has never a stage of vice, is confirmed 
by authorities abroad. Dr. Boddington, of England, is 
emphatic in calling it a disease from the time of the first 
narcotic or toxic action of alcohol." 

If this view is accepted, and the boundary line is made 
the toxic action of alcohol, then the position is the same 



20 ALCOHOLIC INEBRIETY. 

as that occupied by those who recognize the vice as 
ante-dating the use of alcohol. It is important, however, 
to appreciate the fact, that there is a point where the 
poison of alcohol produces its specific effect, and that the 
craving for drink is coincident with this crisis in the 
career of the individual. The desire now conies from 
a physical cause; a toxic impression has been made upon 
the organism in some part, and its effect is to reproduce 
itself, and intensify its demands. 

In connection with this branch of our subject, and in 
seeming confirmation of the views of Dr. Crothers, I 
may state that, in a recent review of my own clinical 
records, I find an almost constant and uniform coinci- 
dence of disorders of various kinds, which I originally 
marked as only complications — hernias, hemorrhoids, 
strictures, venereal symptoms, gastric and hepatic trou- 
bles, rheumatism, neuralgias, cystitis, chronic ulcers, and 
a variety of minor accidents and deformities — but at the 
time I had no thought of entering them upon the record 
as having any causal relation to inebriety in either of 
its forms. Not until my attention has been more 
recently called to it, have I thought of correlating these 
several conditions with the fact of intoxication, in any 
other than an accidental relation. I am, however, more 
and more disposed to study them together, as there is 
probably a definite, though unobserved dependence upon 
each other. 

Dr. J. Milner Fothergill, of London, in a letter to me 
recently, in relation to insanity, thus expresses himself. 

" I am familiar with a case where wild delirium is 



THE VICE ASPECT. 21 

the accompaniment of acute indigestion." In a paper 
he has kindly sent me to read before the " National 
Association for the Prevention of Insanity/' the same 
views are strongly presented. 

Assuming that gout is due to an excess of lithie and 
uric acids in the blood, and that this vitiated and pois- 
oned blood, penetrating and accumulating in the cerebral 
vessels, produces brain disturbance, and of course unusual 
conduct, which is not unfrequently pronounced insanity, 
why may not the insanity-tendency exhibit itself in the 
propensity to drink to excess, the drinker being uncon- 
scious at the time of any relation between his morbid 
diathesis, whatever that may be, and his habit of intoxi- 
cation? 

The same may be said of biliary products, which are 
proverbially connected with mental gloom and depres- 
sion, and it would seem that any irritating or disturbing 
centre, located where it may be, would be competent to 
awaken either a psychical impulse to drink, to relieve 
morbid sensations, or to disclose a brain affection, which 
in, and of itself, predisposes to intoxication. What is 
true of gout and allied morbid conditions, in their 
relation to insanity, may be equally true as to inebriety, 
and if so, it would seem improper to diagnose simple 
acute drunkenness without reference to the history of 
the individual. It is but just to award to the inebriate 
whatever his history, and constitution may demand, in 
the way of extenuation. 

Dr. Fothergill further says that "the brain can no 
more do its work properly and smoothly, when poisoned 



22 ALCOHOLIC INEBRIETY. 

by uric acid, than the patient can have an elastic tread 
with a gouty foot." He goes so far in harmonizing the 
symptomatology of gout and insanity, as to place them 
side by side, in their consequences as to responsibility of 
conduct, and says, in referring to irregular conduct, "It is 
the perversity and cantankerousness of a gouty phase of 
mind — gout in the brain indeed — and the recording 
angel will probably make a note to that effect, for a plea 
of extenuating circumstances at the last Assize." 

I conclude the consideration of the vice aspect by the 
following quotations, most of which are taken from the 
reports of a Select Committee on Habitual Drunkards, to 
the House of Commons of England, 1872. 

Dr. Forbes Winslow, m. d., d. c. l., Oxon, a distin- 
guished teacher and author, says : — 

"There is an enormous mass of drunkenness in the 
lower classes which cannot be traced either to mental 
or brain disease, in the right acceptation of these 
words." 

"I think there are habitual drunkards, as there are 
habitual prostitutes, and persons who habitually indulge 
in any other form of vice. It is their natural and 
normal state." 

te You may have ordinary licentiousness, which you 
may see in all parts of London, in the public streets. 
That is a vice which is very difficult to deal with, except 
by the police ; but that vice sometimes passes from the 



THE VICE ASPECT. 23 

normal into an abnormal state, and the exaltation of the 
instincts becomes a disease, or mania." 

Dr. Alexander Peddie, f.r.c.p., of Edinburgh, 
says : — 

"The habit of drinking sometimes goes on in a slow, 
stealthy manner, as if from vice to disease, and binding 
in the last link the victim, as a slave of a passion from 
which he cannot free himself, struggle however hard he 
may. The disease therefore may be acquired, springing 
out of vicious courses." 

Dr. J. Critchton Browne, of London, Lord Chancel- 
lor's visitor of lunatics, says : — 

" Habitual drunkenness is a vice" 

" Dipsomania is a disease." 

"In drunkenness,, the indulgence of the propensity is 
voluntary, and may be foregone, and in dipsomania it is 
not. The vice may become involuntary, and a disease." 

"Dipsomaniacs are indifferent as to their relatives 
and friends, and their moral nature is degraded. With 
habitual drunkards that is not necessarily so. Burns, 
Collins, Poe and other poets have been addicted to drunk- 
enness, and their later works have been as good as their 
earlier. In certain cases the drunkard becomes a dip- 
somaniac. If he is predisposed to nervous disease or 
insanity, he invariably becomes a dipsomaniac." 

"When a common drunkard has irresistible craving, 
says he cannot resist it, his affections are weakened, his 
intellect fails, his will becomes weak, and he neglects 
his affairs and his family, he has crossed the line, from 
vice to disease" . 



24 ALCOHOLIC INEBRIETYe 

Dr. Geo. W. Mould, Superintendent of Royal Lunatic 
Asylum, Manchester, England, says : — 

"Intemperance as a vice is the result of vicious and 
immoral habits. Intemperance as the result of a disease, 
is attributable to an impulse which the patient cannot 
control. In the other stage, he can be made to control it." 

THE CRIME VIEW. 

Crimes are undoubtedly committed by persons who 
are under the influence of strong drink; but it is 
important to discriminate between the criminal who 
drinks as he smokes, or indulges in any other vicious 
habit, and the criminal who drinks for the purpose of 
aiding him to commit crime. In the one case, drinking 
is but one of a series of evil practices, which may or 
may not be excessive and injurious. In the other case, 
liquor is imbibed for a purpose, and that purpose is to 
strengthen the daring or courage, and enable a person 
with criminal mind, to be bold or audacious enough to 
proceed with his intent, and accomplish it. The one 
maybe noted on the court docket, or on the prison roster, 
as intemperate or not ; according to the judgment or 
habit of the justice, or the warden. The other takes 
care not to imbibe enough to induce profound intoxica- 
tion, and thus betray himself, and yet he drinks enough 
to entitle him to be registered as a drunkard. He takes 
his draught of whisky, in just the quantity needed to 
harden his conscience for the time, and nerve his arm 
for the intended deed. He is the possessor of a criminal 
mind, and is bent on a criminal act. He is criminal 



THE CKIME VIEW. 25 

first, and drinker afterward. On the court and prison 
records he has no right to appear as a drunkard. Pos- 
sibly the least of all his vices,, is his drinking habit, if 
indeed it reaches the measure of a habit. He procures 
his liquor for the same reason, and with the same delib- 
eration, that he purchases his weapon. Indeed, his cup 
is one of his weapons. He avoids inebriation that he 
may succeed in his purpose. Among professional crimi- 
nals, such men are not few. They are too shrewd to 
become intoxicated. Let me furnish illustrative cases, 
which I take from my own journal. 

No. 78. Aged 29. Clerk. Drinks to excess occa- 
sionally. Latterly, the occasions have been so frequent 
that he has lost his situation. Upon further acquaint- 
ance w T ith this youth I found him honorable and 
honest, when sober, an excellent clerk, obliging, and 
given to no other habitual vice, than excessive smoking. 
He is sensitive, and has recently become suspicious to 
a degree that makes intercourse and conversation with 
him a very delicate matter. At times, he was overtaken 
with an impulse to commit an act that was in violation 
of his conscience and moral sense, but which seemed to 
be irresistible. The very conflict with himself and his 
temptation, aggravated his nervousness, and he became 
willful, obstinate, profane, and restless to a degree that 
was irrepressible. In this stage of extreme irritability, 
he would resort to whisky in great moderation. Unlike 
the dipsomaniac, who drinks without limit, and without 
thought, he drank with great caution, taking a little at 
a time, with short intervals between. As the circulation 
3 



26 ALCOHOLIC INEBRIETY. 

began to create a glow throughout his whole capillary 
system, and his extreme nervousness began to yield to a 
state of comparative calm, the period for deliberation 
was reached, and keeping himself at this level, by 
repeated draughts of liquor, at suitable intervals, he was 
enabled to plan and execute. His offence was always 
the same, and after it was done, he suffered remorse, 
and sorrow, and till the next overpowering impulse 
possessed him, he was prudent, sober, and correct. 
This young man afterward settled in business, and 
became a useful citizen. His friends consider him 
a " reformed drunkard," and he is willing to accept 
the title. He is, however, a reformed criminal, if the 
propensity to crime is in subjection ; but he was never 
an inebriate, in its actual physiological sense. 

No. 180. Age 41. An agent for a large mercantile 
firm, w 7 ho, with a clear head and steady hand, executed 
a forgery, and then deliberately got drunk, to partially 
obscure from his mind, thoughts of his deed, but more 
especially to furnish his friends with a plea for commit- 
ting him to an inebriate asylum, the officers of which 
were unconsciously instrumental, for the time, in aiding 
a criminal to escape the just sentence of the law. I am 
not aware that this man was ever intoxicated afterward, 
w r hile previously to this time, he bore a reputation for 
sobriety. He was not an inebriate, but a criminal, and 
yet the fact of being sheltered for a short time within 
the walls of a Sanitarium, gave him the opportunity to 
pass, on his discharge, for a reclaimed victim of the 
bowl, which he preferred to the shame of being a forger. 



THE CRIME VIEW. 27 

Another case that came under my observation, but 
not under my care, was a convict in a State Penitentiary 
for the third time, for manslaughter. I shall narrate no 
more of his remarkable history, than will serve to illus- 
trate the topic in hand. Notwithstanding his homicidal 
tendency, which seemed to be inherited, he acknowledged 
himself to be a coward, and it was always with much 
fear, that the impulse to kill was, associated. Instead of 
the daring, and even rashness of some homicides, he 
trembled with terror as the impulse to destroy life, seized 
and possessed him. The conflict between the impulse, 
and the timidity and dread, which were almost simulta- 
neous in their approach, made him nervous, irritable and 
angry. Like Number 180, under these conditions, he 
resorted to the liquor in such carefully graduated quan- 
tities, as he imagined would secure care and deliberation 
in the prosecution of his purpose. His purpose was to 
select a victim whom he could manage with ease, always 
keeping himself in the attitude of self-defence, that he 
might evade the extreme penalty of the law for murder. 
He could, while his own anger and irritability were under 
control, excite his antagonist to threats, or attempted 
assault, during which period he would calmly and surely 
inflict the fatal wound, under the pretence of saving his 
own life. This sort of proceeding had been practiced with 
success three different times, on which account he had 
spent most of his adult life in prison, and before his 
present term expires, he will probably die in his cell. 
He described to me with evident clearness, and certainly 
with considerable self-satisfaction, the details of his pro- 



28 ALCOHOLIC INEBRIETY. 

ceedings, and manifested no evidence of remorse on 
account of his guilt. The cause of his crime on the 
prison docket was "intemperance," and he was willing 
to accept this record as true, because it was written, for 
he did not appreciate the enormity of the crime, nor the 
guilt of a criminal. He should not have been so reg- 
istered. He is not a drunkard, but a murderer; the 
criminal intent was in his mind; the objects of his 
assaults were selected, and plans laid to decoy and 
irritate them, before he drank the whisky to aid his 
brutal instinct, and nerve him for the fulfillment of his 
diabolical purpose. He represents a class, and I doubt 
not, if a careful analysis was made of the character and 
habits of convicts now in confinement, the discovery 
would be made, that many whose crime-cause is stated 
to be intemperance, would be found to be like the one 
just stated — temporary drunkards for a criminal purpose. 

Inebriates proper are not inclined to criminal acts. 
Dr. Arnold, of Baltimore, speaks of them thus: 

" Inebriates do not form that class of people who plan 
and carry out schemes of villainy and corruption, in high 
and low places; nor are they usually found on the list 
of professional criminals who figure in our courts of law. 
Besides, it is notorious how often criminals try to miti- 
gate the heinousness of their offences by attributing 
them to the effects of alcohol." 

It should be borne in mind also, that the very habit of 
intoxication, disqualifies persons from committing some 
crimes. The habitual and excessive use of intoxicants, 
promotes timidity, incautiousness and inefficiency, and 



THE CRIME VIEW. 29 

failure is the almost invariable result of attempts to com- 
mit certain kinds of crime, by those who indulge in intox- 
icants. An expert was some time since employed to search 
the records of crime in a neighboring State, with the view 
of ascertaining from official sources, the number of persons 
convicted of murder during the past hundred years, with 
the causes, penalties, etc., etc. After a careful and pains- 
taking examination of court and prison records, it was 
reported, that less than three per centum of such crimes 
could be traced to the use of intoxicating liquors. Upon 
this disclosure being made, it was repeated to a prominent 
temperance advocate of the same State, who confirmed 
its accuracy, by saying that he had caused a similar 
investigation to be made, with the same result, but added 
that he hesitated to make it public, because it would 
deprive advocates of temperance of a cogent argument 
in behalf of the cause. Pursuing the same line of in- 
quiry from time to time, it fell in my way to ask a very 
worthy Chaplain of a Penitentiary, how many of the 
several hundreds of convicts under his care, could con- 
nect their crimes with the use of intoxicating drinks. 
His reply was, that from direct personal knowledge of 
the history of each prisoner, he believed they were all 
guilty of vices, such as gambling, profanity, falsifying, 
tobacco chewing, smoking to' excess, and lewdness, etc.; 
but-to which of these vices their particular crime was to 
be attributed he could not tell, but that it would be 
about as easy and fair to trace it to one as to another; and 
he added, " Those whose crimes are the direct result of 
intemperance are very few. I do not know of one" 



30 ALCOHOLIC IKEBEIETY. 

It would be more philosophical to go behind and beyond 
them, to the source from which they all spring, namely, 
a depraved physical and moral nature. Being children 
all, of the same stock, their conduct and behavior 
originated in one common source, and it takes either 
line that is indicated, in accordance with the direction 
of certain physical tendencies. 

The Hon. Richard Vaux, of Philadelphia, distin- 
guished as a penologist of rare powers, and opportunities 
for observation, writes me as follows : 

" I do not consider intemperance, as it is called, 
— inebriety, — the use of intoxicants, as a crime-cause. If 
this were so, all inebriates would be criminals. Now, 
the fact is, that criminals are made so by other causes ; 
and they, like the rest of mankind, use intoxicants or 
do not use them. It is now forty years since I have 
been an Inspector of the Eastern State Penitentiary 
in this city, and I have no hesitation in saying that 
intemperance — the use of intoxicants habitually, or 
to excess — is not a crime-cause. I think it can be said, 
that about one-half of those convicted of crime are 
total abstainers. Of the four hundred and thirty- 
three (433) prisoners received into our Penitentiary 
in 1881, but twenty-six (26) were intemperate. Mr. 
Cassiday, our warden, who has been in the service 
of this prison for twenty years, gives his experience in 
support of these views of crime-cause. I know it is a 
sort of fashion to talk about our prisons filled with the 
victims of intemperance, but the figures do not support 
this general and sweeping assertion." 



THE CRIME VIEW. 31 

In confirmation of the same views, I am furnished 
with the following, from the accomplished General G. 
Mott, late keeper of the New Jersey State Prison, at 
Trenton : — 

" I am decidedly of the opinion, that our Peniten- 
taries are not filled with those who trace their crimes 
to intemperance; that class fill our common jails, lock- 
ups, and Houses of Correction. A person sent to a Peni- 
tentiary, no matter for how short a time, for a violation 
of the law, perhaps committed in the heat of passion, 
and while under the influence of liquor, is branded a 
criminal; thinks society has injured him, and when he 
gets out, may join the criminal class, as he says, 'to get 
square ; ? but he must keep sober if he expects to get in 
with the expert. The majority of criminals who fill 
our Penitentiary are primarily of a criminal mind, born 
so, and brought up to prey upon the general community ; 
but they are not habitual drunkards, nor do they asso- 
ciate with that class. Not so themselves, because, to be 
an expert, they must keep their heads cool, and their 
wits about them ; and their associates must do the same, 
as they know there is no dependence on a drunken man; 
for, when in that condition, he may let something drop 
that, perhaps, will lead to the failure of their plans and 
the probable detection of the principals." 

The following is also contributed from the Maryland 
State Penitentiary. 

"Out of five hundred and thirty-four (534) convicts 
in November, 1881, there were strictly temperate one 
hundred and seventeen (117); moderate drinkers, two 



32 ALCOHOLIC INEBRIETY. 

hundred and forty-two (242) ; occasionally intemperate, 
one hundred and seventy-one (171), and habitually in- 
temperate, four (4)." 

From Mr. John C. Salter, the successful Warden of 
the State Penitentiary at Chester, Illinois, I learn the 
following :— 

" The popular sentiment seems to be that a criminal 
must necessarily have been a drunkard. That this class 
are frequenters of saloons, and are more or less slaves 
to appetite for strong drink, as they are to other vices, 
cannot be denied. The large proportion of criminals, 
such as burglars, forgers, counterfeiters, need clear 
brains, steady nerves, and quick perceptions, to success- 
fully carry out their plans, which would be impossible 
under the influence of intoxicating drink. I am more 
and more convinced that the causes of crime go away 
back in the history of the criminal, even outside of his 
own life, coming down from generation to generation, 
visiting the iniquities of the fathers upon the children. 
Lack of home influence, throwing boys and girls of 
tender age out upon the charity of the world ; lack of 
the discipline of education, the haste to get rich, and 
the false standard of greatness ; are causes that have 
done much toward filling our jails and penitentiaries 
with those who, under more favoring winds, would 
have found shelter in a friendlier harbor." 

The apparent discrepancy between the commonly 
accepted belief, that at least two-thirds of all the crimes 
are due to intemperance, and the actual facts, as derived 
from institution statistics, may perhaps be accounted for 



THE CHIME VIEW. 33 

thus: The offences for which persons are sent to 
houses of correction county jails, and lock-ups, are 
largely attributed to strong drink as an exciting cause, 
while the more grave offences are punished by commit- 
ment to penitentiaries. Also, the commitments to the 
common places of detention, are counted over and over 
again, and the evil is made to appear, as we shall 
presently see, much more formidable than the facts 
really justify. Vagrancy is an offence that does not 
find its way to penitentiaries, and yet it occupies a con- 
spicuous place on the common jail records. Vagrancy 
is often associated with drunkenness, but not always as 
cause and effect. Pauperism and vagrancy are usually 
associated with a low and depraved physical and moral 
constitution. In many cases, the tendency is to despond- 
ency, and despondency is frequently an exciting cause of 
intemperance. If, therefore, vagrancy is counted as crime, 
and every vagrant who drinks is counted as intemperate, 
it can be readily seen how so large a percentage is given 
to intemperance as a crime cause. So, if intoxication is 
counted a crime, and, to use the police nomenclature, if 
" drunk and disorderly " is a title attached to every 
commitment for intemperance and vagrancy, the showing 
in that direction must necessarily be exaggerated. And 
yet it is just about in this careless manner that the police 
records are frequently kept. A scientific nomenclature 
is unknown to the law, while the docket of a police 
justice, cannot be more than a transcript of the justice's 
own ideal of what is, and what is not crime, or disease. 
Crime usually has its source in the mental or moral 



34 ALCOHOLIC INEBRIETY. 

constitution. The desire for alcoholic beverages is 
generally a physical desire, an animal lust, and has but 
a distant, if any, relation to what is recognized as the 
moral character. Poison acts primarily upon the blood 
and upon the nerve centres, while the moral aspect 
of the case is remote and incidental. The American 
Association for the Cure of Inebriates expresses this 
thought forcibly in the following resolution, which was 
adopted at their Annual Meeting at New York city, in 
1871. 

" Resolved, That the effect of poison on the blood and 
nervous system, and the reflex action of this morbific 
agent upon the whole physical structure, is the same in 
the virtuous as in the vicious, and that antecedent or 
subsequent moral conditions are incidental to the main 
fact of disease." 

As drinking is the outcome of physical states, so also 
social conditions contribute their share towards the 
same result. Bad food, unventilated dwellings, low 
companions; whatever contributes to lower the tone of 
bodily vigor, tends also to drunkenness; and yet, in 
arranging a table of causes, these important factors are 
but seldom, if ever, noticed. It is a question, the solu- 
tion of which is now approaching its crisis, whether 
vagrancy is not as much an exciting cause of drunken- 
ness, as intemperance is of vagrancy. Certain it is, 
however, that it is as unphilosophical as it is unjust, to 
formulate a law or rule upon which to base conclusions, 
without a rigid analysis, not only of criminal records, 
but of the life, previous character and tendencies of 



THE CRIME VIEW. 35 

tho^e who commit crime. To do this under the present 
system of keeping such records is an exceedingly diffi- 
cult task. To register commitments, and not persons, is 
a most misleading method, to say the least of it, and 
until it is abandoned, and a system based upon actual fact, 
and individual knowledge, is recognized as proper, and 
adopted, we shall, perhaps, never make much progress. 
I know of a single man being committed to an asylum, 
and discharged thirteen times, and registered each time 
as cured of insanity, thus being made to represent on 
the record, thirteen distinct cases of insanity, and thirteen 
cures. The student of crime-cause and prison discipline, 
must frequently notice this method, and be impressed 
with its unfairness. 

The criminal history of Great Britain furnishes some 
striking facts in this connection. 

A noted " repeater," or " prison-bird," as such per- 
sons are sometimes called, was the notorious Margaret 
Mitchell, of Scotland, w r ho was subjected to forty-two 
commitments, mostly for drunkenness and disorderly 
conduct, being two hundred nights in police stations, and 
seven hundred and seventy-eight days in Glasgow 
Prison, and in various jails, shelters, refuges, hospitals, 
etc., for short terms, in each of which she was, of course, 
registered as a distinct and different individual, and was 
made, under her forty-tw T o separate commitments, to 
represent an equal number of cases, being variously 
recorded with the appended offence, as " drunk and 
disorderly," " indecent conduct," " annoying her hus- 
band on the street," "annoying her husband at his place 



*36 ALCOHOLIC INEBRIETY. 

of business," "outrageous conduct/' "outrageous and 
profane language/' etc., etc. 

To continue extracts from the Parliamentary Blue 
Book, containing "minutes of evidence" before a Com- 
mittee of the House of Commons, I find that William 
Smith, Governor of the Prisons at Ripon, reports as 
follows : — 

"I have one case of drunkenness; the case of a 
woman who has been in Wakefield jail seventeen times, 
in Leeds jail eleven times, in Northampton jail fifteen 
times, in Ripon jail fifteen times, all for being 'drunk' 
and ' drunk and disorderly.' " 

This woman was committed fifty-eight times, and if 
she did not represent fifty-eight separate individuals, 
she did count in each jail as a separate case, under a 
fresh commitment each time, and under a new alias, as 
Thompson, alias Fox, alias Connelly, etc., etc. Mr. 
Smith also reports the case of a man who was enrolled > 
in several prisons as Wolf, alias Blanche, alias Murray, 
alias Johnson, who, during a period of eight years, was 
sent to five different prisons twenty-two times, and in 
each case there was the offence of assault added to that 
of drunkenness. I might repeat a variety of illustra- 
tions of a similar character, from the same source, but 
these are sufficient to emphasize the fact that such records 
are not reliable, as indicating the existence of crime, as 
to its extent, or the number of its victims. With me it 
is no longer a question of doubt, whether intemperance, 
vagrancy and pauperism are not triplets in the vice and 



THE CRIME VIEW. 37 

crime family, having a common origin, being born of 
one parentage, dwelling and thriving in a common 
atmosphere, and capable of living separately or together, 
as circumstances or accident may determine. The records 
of crime and disease, and the observation of experienced 
observers confirm and ratify the opinion. Certain it is 
that phthisis, insanity and epilepsy, and possibly other 
diseases, existing either together or separately in a 
family, constitute a basis for the physical character of 
offspring that is transmissible, and is transmitted as an 
inheritance that is alike common to criminals, lunatics 
and dipsomaniacs. In the 52d Annual Report of the 
State Penitentiary for the Eastern District of Pennsyl- 
vania, I find a most suggestive and instructive table, 
showing the relationship between crime and disease in 
sixty-three convicts, which seems to confirm the above 
statement. The table designates certain diseases that 
stand related to crime with such uniformity as almost to 
warrant the expectation of a similar coincidence of rela- 
tion, if applied to the whole catalogue of crimes. In 
these cases, larcenies, felonies, conspiracies, arsons and 
murders seem to have substituted the diseases which 
have manifested themselves in the preceding generation, 
and to play an important part in the family history, 
exhibiting the constant interchange between physical 
and mental disorders. 

For example, eight cases of manslaughter, and murder 
in the second degree, twenty-six of larceny, and numer- 
ous other crimes in various members, and all, with 
scarcely a variation, coming from families in which either 



38 ALCOHOLIC INEBRIETY. 

insanity, epilepsy or phthisis existed as the recognized 
family disorder, and in some of the families each of the 
three diseases did its share of destructive change, which 
was visited upon the next generation in the form of crime. 

The following extracts from the testimony given before 
the House of Commons Committee on Habitual Drunk- 
ards, is offered to confirm the views of this chapter. 

Dr. Arthur Mitchell, of Edinburgh, the distinguished 
Commissioner in Lunacy for Scotland, says : — 

" There is a difference between ordinary criminals and 
the man under restraint for habitual drunkenness. " * 
* * " I think you would do him (the drunkard) no 
good, if you did not in some measure treat him as a 
person laboring under disease, and if you place him in 
an ordinary prison you must treat him as an ordinary 
prisoner." * * * " The prison is not the proper place 
for the treatment of drunkards." 

Mr. William White, Surgeon and Coroner for Dublin, 
Ireland, says : — 

" I think that men with delirium tremens very rarely 
commit homicide. They are cowardly, and seldom 
have courage to attack any one." 

Mr. H. Webster, Governor of Prisons at Kingston- 
upon-Hull, England, says : — 

" The expert thief is always a much sharper class of 
prisoner (than the inebriate). He is quite a different 
type, I do not think that they are lower than ordinary 
criminals, excepting after they have given way to drink, 
and then their minds become impaired." 



THE CRIME VIEW. 39 

" Drunkards are altogether unfit for prison ; they are 
not the men to be associated with ordinary prisoners. 
I would never commit a drunkard to a prison at all." 

"Small offences, petty larcenies and that sort of 
offence, are almost invariably the outcome of drunken- 
ness" * * " not great offences, but petty offences." 
* * " Almost universally, in cases of robbery, the prose- 
cutors have been drunk at the time." 

"Those sort of cases, almost invariably arise from 
drunkenness on the other side." 

Dr. Charles Robert Bree, a practicing physician of 
Colchester, England, says :— 

" Drunkenness is not a crime like that committed 
by those with whom they associate in jail ; and they 
get a good deal worse by being sent to jail." 

Mr. William Smith, Governor of Prisons, at Ripon^ 
Ireland, says : — 

" Those who are habitual drunkards are not really 
thieves : there is a distinction." " A thief is one who 
undoubtedly takes to drink to a certain extent, but he 
always takes care about getting drunk, because if he 
gets too drunk, he cannot commit the felony." 

" One woman was committed for drunkenness fifty- 
eight times, but without having committed a felony 
once." * * " Out of eighty prisoners, eight to ten 
were drunkards." 



40 ALCOHOLIC INEBRIETY. 

INEBRIETY A DISEASE. 

In entering upon the consideration of the aspects of 
disease, it is important to discriminate between the dis- 
ease proper, and its morbid anatomy, in order to obtain 
a clear conception of its character. The unprofessional 
reader will be aided in his ability to comprehend this 
difference, by noticing the following definitions : In any 
given case of disease, the enquiry naturally embraces 
the causes, .the symptoms, and the morbid effects pro- 
duced upon any of the organs or tissues of the body. 
The causes and history of a disease are spoken of as 
its etiology. The symptoms, as its symptomatology , and 
its morbid effects upon the organs, as its morbid anatomy. 
Neither of these, however, will furnish any correct notion 
of pathology, an idea of which we shall obtain as we 
consider causes and symptoms, and trace their connec- 
tion with a primary state of the system, in which we 
recognize a special tendency to particular forms of dis- 
ease, known as a constitutional diathesis or predisposi- 
tion. With the symptoms and effects of alcoholic 
intoxication most persons are supposed to be familiar in 
a general way, and yet there is a degree of ignorance of 
causes that is not in keeping with the general intelli- 
gence of the people on most subjects. 

Not far from a century ago, Dr. Rush, of Philadel- 
phia, attributed drunkenness to a " morbid state of the 
will." Esquirol, a distinguished French author and 
teacher, said : " There are cases in which drunkenness 
is the effect of accidental disturbance of the physical 



INEBRIETY A DISEASE. 41 

and moral sensibility, which no longer leaves to man 
liberty of action." Dr. James Critchton Browne, 
recently of the West Riding Asylum, England, says : 
" Dipsomania consists of an irresistible craving for alco- 
holic stimulants." * * * « Sometimes the craving be- 
comes altogether uncontrollable." * * * «j recollect 
the case of a gentleman, perfectly sober, who had dipso- 
mania, which was attributable to taking a draught of 
water on a hot summer's day, which caused fainting, and 
was succeeded by an entire change of character. Dipso- 
maniacs have no energy or fixity of purpose or strength 
of volition." 

Dr. Alexander Peddie, of the Royal College of Physi- 
cians, Edinburgh, Scotland, says : " Intemperance as 
the result of a disease, is attributable to an impulse 
which the patient cannot control; the habitual drunkard, 
or dipsomaniac, or by whatever name he may be called, 
is destitute of control over himself. In that condition, 
no considerations, temporal or spiritual, have the slightest 
effect in checking the drunkard's progress, if ways and 
means, foul or fair, can be found to gratify the desire 
for alcoholic stimulants." 

If we mark the chief features of this disorder as 
presented by the authorities just quoted, a fair estimate 
may be formed of the pathology, or true nature of the 
disease. 

" A morbid state of the will," (Rush). " Which no 
longer leaves to man liberty of action," (Esquirol). 
" An irresistible craving," " altogether uncontrollable," 
sudden shock, causing "fainting and an entire change of 



42 ALCOHOLIC INEBRIETY. 

character," (Browne). "An impulse which the patient 
cannot control," (Peddie) etc. I might continue quota- 
tions from divers authors, of the same character, but 
prefer to illustrate the facts stated, by cases from my own 
clinical record, as follows : — 

Case 98. An educated gentleman, and an instructor 
of others. Trained religiously, and free from common 
vices. Domestic in his tastes and habits. Studious, 
and inclined at times to solitariness, w^hen he usually 
resorted to his study, and desired to be left alone. This 
was generally the prodromic sign of an impending de- 
bauch. With locked door, and introspective mood, he 
would sit by the hour, meditating and struggling with 
endeavor to crowd out, and banish from his thought the 
propensity to leave his home, and drink. It came upon 
him unbidden, lingered with him, and at last became 
imperious and commanding. The resistance of his con- ■ 
science and his convictions, seemed to intensify the force 
of the impulse, and, of course, to aggravate his dis- 
quietude, and increase the desire to indulge in what he 
knew would cause him to forget his troubles. Parental 
remonstrance, the attempted assertion of his own man- 
hood, the resistance of his moral nature, were of no 
avail. In addition to these, the prospect immediately 
before him, of the low saloon ; the boisterous company 
within, the emptied purse, the arrest, the lock-up, and 
the resulting shame and remorse, all passed like a pano- 
rama before him, but he heeded nothing, till his debauch 
was accomplished, terminating, as it always did, in pro- 
tracted oblivion. He invariably.attributed his defection 



INEBRIETY A DISEASE. 43 

to indescribable sensations at the epigastrium. Placing 
his hand over the region, he would cry out. " Stomach ! 
oh, stomach! why do you torment me?" And speak- 
ing of his other sensations, described them as accom- 
panied by a sense of darkness and sadness, enveloping 
him, as it were in a cloud, by which he was borne 
almost unconsciously from his home, to the haunts that 
he frequented. What he did after the first draught, 
which was invariably full and strong, he knew not. I 
do not mean that he was in a drunken sleep all the time, 
for he was not. On the contrary, he was active, busy, 
and restless, but he was led by a force that he could not 
master. He seemed, in movement and utterance, to be 
purely automatic; an invisible force guided his steps, 
and at last, held him in the bondage of a complete nar- 
cotism, that lasted several hours, and was the invariable 
culmination of his attacks. When the chain was broken, 
and the emancipation was complete, he could recall 
nothing that happened after his first drink. Moilths 
would sometimes intervene before another attack. It 
was always announced, however, by the same prodromic 
period. 

His stomach disorder was concealed for a long time, 
because it was associated in his mind with debauchery 
and shame, and a desire for seclusion and loneliness. 
It might be called the second stage of his attack, the 
third being a period of active, restless and boisterous 
intoxication, terminating in a long and profound sleep. 
These were his uniform symptoms. The climacteric 
period is now passed in his case, and he is a sober, useful, 



44 ALCOHOLIC INEBRIETY. 

Christian citizen. Review the points here stated, a 
moment; a thoughtful, educated gentleman, no training 
by a previous habit of moderate drinking, no influence 
from association with drinking companions, no tempta- 
tions from without, but a deep-seated nervous disorder, 
gnawing at the vital parts, and demanding relief, but 
aggravated, doubtless, by a family taint of insanity ! 
These are the points. 

Dr. Arthur Mitchell, Commissioner of Lunacy for 
Scotland, says : that in some cases " frequent habitual 
drinking precedes this state, but that it is not neces- 
sary; it may sometims appear without previovs habits 
of drinking, as the result of cerebral injury; the result, 
for instance, of fever, of hemorrhage, of mental shock, 
of the commotion in the system which attends the estab- 
lishment of puberty, or the arrival of the climacteric 
period." 

Dr. Geo. Burr, of Binghamton, New York, says : "It 
is the propensity or desire to indulge in the use of 
ardent spirits, and not the habit of drinking to excess, 
or drunkenness, and its subsequent effects, that is to be 
regarded as the morbid condition. A broad distinction 
must be made between the two ; the latter is but the 
development of the former. The propensity, when 
under the influence of the exciting causes, arouses the 
appetite, overcomes the will, blunts the moral sensi- 
bilities, and makes everything else subservient to its 
demands. The habit is the natural sequence of the 
growth and development of the propensity. The one 
bears the same relation to the other that the eruption 



INEBRIETY A DISEASE. 45 

of smallpox bears to the contagion of that disease ; or 
the several stages of an intermittent fever, to the poison 
of malaria. The delusions of the insane are but the 
morbid phenomena of minds disordered ; so, the love 
of the bowl, and the self-destructive acts of the inebriate, 
are likewise the manifestations of a condition of the 
organism, that may well be regarded as diseased." 
Here we have a pathological state referred to, that is 
often described by those who possess it, as a state of un- 
rest. Dr. Arthur Mitchell, already quoted, describes it 
as "an ungovernable and remitting craving for drink, 
which has no reference to anything: external ; it comes 
from something within." 

An ungovernable craving ! that is the pathological 
state, whether it originates in the nerves of the stomach, 
in the brain, or elsewhere. Whether it is the result of 
inheritance, of imprudence, or of accident. 

There is another view, that traces its pathology t6 the 
alimentary system, that is worthy of consideration, and I 
offer the following extract from a lecture I delivered 
before the Medical and Chirurgical Faculty of Maryland, 
in 1874,* in which the following language was used : 
" Our appetites differ widely as to the ordinary articles 
of diet ; what is delicious to the taste of one, is offen- 
sive to the taste of another. Especially is this mani- 
fested in eccentric diversity, in certain forms of disease, 
as in hysteria and chlorosis. Lime, chalk, clay, etc., 
are, as we all know, eaten with relish in such cases ; 
and how often do we see children, eat plaster from the 
* Yide li Transactions'' for that year. 



46 ALCOHOLIC INEBRIETY. 

wall, slate pencils, etc., not, certainly, because they satisfy 
the gustatory sense, but because there is a constitutional 
demand for them, to which even the common instincts 
of childhood answer, without the intervention of any 
theory or knowledge on the subject. Such cases evi- 
dence a disordered alimentation which the physician 
proceeds to correct, and which is amenable to his correct- 
ive processes. We are also familiar with analogous 
eccentric demands of appetite or longing, in pregnancy, 
and in cases of convalescence from fevers; the strongest 
and apparently most indigestible articles of food are 
frequently required, and I suppose, generally allowed, 
in such conditions, with no apparent disadvantage." I 
therefore place the excessive demand for alcoholic stimu- 
lants, in some cases, among this class of diseases. 

It is quite probable that in the organic changes which 
take place in the processes of life, and which we call 
waste, there are periods when the diathetic condition, 
originally occult in the germinal existence, may become 
apparent, and manifest itself in appetites or passions 
which were before not known. We see this fact exem- 
plified in the growth of the individual. The infant has 
no desire or capacity for the food of manhood ; but with 
dentition and early childhood, new appetites begin to 
declare themselves, which are modified as life advances. 
Waste may not always be supplied by the same material, 
even in the same individual. Age, occupation, climate, 
and habit of life must, to a considerable extent, regulate 
the quality and quantity of the alimentary substance; 
and as there are conditions in disease which require 



INEBRIETY A DISEASE. 47 

alcoholic stimulation, so there may be changes in the 
structure, from natural or accidental causes, which seem 
to demand their use, and in which the demand is some- 
times imperious. I may in this connection, also invite 
attention to that inordinate craving for food which is 
known in science as Bulimia or Polyphagia, in which 
condition there is an excessive demand for ordinary 
healthy food, in quantities far beyond the needs of the 
systeai. It is commonly called gluttony. It may be, 
like drinking, a sensuous habit merely, running on till 
it assumes the form of gastric disease; but it is more 
frequently a symptom of cerebral disorder. There are 
certain forms of mental derangement, in which it is a 
characteristic symptom, sometimes assuming the form of a 
voracious demand for unnatural food, as for raw or spoiled 
meat, candles, etc. I have seen it frequently manifested 
in idiocy, to a most revolting degree. It differs from 
the revived and invigorated appetite of convalescence 
from protracted fevers, and is one of the most offensive 
and disgusting types of animalism to which the. human 
species can be reduced. Allusion has already been made 
to the chlorotic appetite of females; a morbid craving 
for particular things, and especially those that are innu- 
tritious, which Dr. Flint says is sometimes due to a 
" morbid uneasiness at the stomach." This is the very 
symptom so often referred to by intemperate persons, 
and the more I compare the pathological states of the 
different classes, the more striking does the similarity of 
condition appear. The stories of dirt eating that come 
to us from the plantations of the West India islands, 



48 ALCOHOLIC INEBRIETY. 

and of our own Southern States, intensify the fact and 
emphasize its pathological importance. Dr. Duncan, of 
Louisiana, believes this practice of dirt eating (Chtho- 
nophagia) to be due in many cases to "a diseased 
condition of the digestive organs." 

Again we find one other feature common to all these 
states, namely, a certain perversion of the moral sense, 
leading to deception and falsehood, regarding their habit. 

The intimate relation that exists between the moral 
and intellectual tastes and propensities, and those that 
are physical, and the retroactive influence of mind and 
matter, lead to the thought, that while it is true, that 
disordered alimentation in some cases is due primarily 
to gastric disturbance, or to morbid impressions upon 
the gastric nerve centre, it is also true that in other 
cases, the abnormal sensations are due to the brain, or 
to that portion of the brain which has to do with the 
function of taste. As hallucinations and delusions are 
evolved from that portion of the encephalon that is 
concerned with the sense of hearing, and which in such 
cases is so distorted by disease, as to create false sounds, 
so may the desire for alcoholics, be evolved from the 
convolutions that are concerned in the function of taste 
and appetite, if from any cause that portion of the 
cerebral mass is under morbific control. 

Whether the disease, therefore, is one originating in 
the brain, or in the stomach, or sometimes in one and 
sometimes the other, is a question which naturally pre- 
sents itself in this place. That it may originate in the 
brain is quite true ; that it may originate in the gastric 



INEBRIETY A DISEASE. 49 

organ is equally true ; that it may be idiopathic, or 
traumatic, is also true, and with but little difference in 
its symptomatology from either variety of causation. 
That it may exist in a form that may be called psychical 
inebriety, is also capable of demonstration. Though I 
believe such cases are rare, and because they are rare, 
or at any rate, are but seldom described, if, indeed, they 
are noticed, I shall now give the outlines of "two cases, 
— a father and son, both of whom were victims of this 
unusual variety of the disease. 

Case 208. A young man possessing rare gifts of 
mind, an only son, in many respects the counterpart of 
his father. They were both professional men of ample 
means, and with but little to think of, except how best 
to enjoy life; and of course each had his own ideal of 
what constituted enjoyment. The father was an extremist 
in religion of the transcendental order, and seemed 
to dwell in an atmosphere that imparted to his inner 
sense, the most exquisite delights, and when not rang- 
ing in invisible spheres, and communing with unseen 
friends, he was intent on securing converts to his faith ; 
and especially was he anxious to enlist the gifted mind of 
his son, in the same pursuits with himself. The son, on 
the other hand, could not adopt his father's ideal, though 
he was envious of his ecstatic nights, and determined to 
avail himself of the intoxicating and bewildering effects 
of ardent spirits, hoping thereby to arouse, if possible, 
similar ecstacies to those of his father's mental state. 
His judgment could not accept the religion of the father, 
though he thought he discovered that its realm was, to a 



50 ALCOHOLIC INEBRIETY. 

great degree, within the scope of a lively imagination, 
and that by stimulating his own powers, he might 
occupy the same field, and enjoy similar fellowships and 
fancies. 

Both parent and son were alike in temperament ; the 
bodily health of each was good, and on more than one 
occasion, both in my presence, and in the presence of 
each other, were earnest and sincere in argument and 
appeal, to convince me that the other was insane. The 
son conceived the father to be a monomaniac on the sub- 
ject of religion ; and the father believed the son to be 
insane, because, not accepting the dogmas of his trans- 
cendentalism, he obtained enjoyment from the bowl. The 
brain of one was disturbed by a faith which inspired 
his conduct to a degree, and in a manner, to warrant his 
being classed with those who — 

"Are drunk, but not with wine," 
and who — 

u Stagger, but not with strong drink." 

The brain of the other, was so far athwart its balance, 
as to believe that he could substitute the intoxicants 
for a religious faith, and draw from their inspiration 
similar delights and enjoyments. By unreasonable 
methods, both sought to realize what they could not 
possess in a normal state, or could not obtain by reason- 
able means. The recompense to each, was in harmony 
with his tastes, and with the means employed to indulge 
them. 

These men occupied the border land between sanity 
and insanity, for a season. They kept pace with each 



INEBRIETY A DISEASE. 51 

other in concurrent lines, during several years, each 
following his own course to its end. Occupying separate 
homes was among the early signs of domestic dissolu- 
tion, and the sequel of the son's career was a permanent 
lesion of the brain, requiring a care-taker for the 
remainder of his life. 

The natural outgrowth of his father's vagaries was a 
gradual but continuous loss of mental poise, and a corres- 
ponding diminution of worldly fortune. Both of them, 
from a common impulse, that was purely psychical, sought 
happiness through channels, that were alike familiar and 
congenial with their tastes, but leading to one and the 
same result. The son reveled in an artificial atmos- 
phere, the product of alcoholic intoxication. The father 
delighted in a rapturous communion with a counterfeit 
w r orld, which was brought within his reach from beyond 
our own sphere, not by the poison of alcohol, but by the 
toxic wand of a bewildered imagination. The brain 
was intoxicated in both cases, and yet neither was an 
inebriate. The father exhibited psychical, and the son 
physical symptoms of intoxication. 

Thus far our investigations have led us to recognize 
the longing desire for intoxication, and the ungovernable 
craving, which has no reference to anything external, and 
not the act of drinking, to be the disease, the cause for 
which may be hereditary, or may be created by the con- 
ditions and conduct, which interweave themselves into 
daily life. 

* There are certain peculiarities, however, which are 
displayed with such remarkable uniformity in the career 



52 ALCOHOLIC INEBRIETY. 

of some inebriates, as to warrant their classification into 
separate groups, and I shall now offer a few examples 
in proof of this statement. 

SOLITARY, MIDNIGHT INEBRIATES. 

Case No. 59. A clergyman, aged 46. Drinking 
habitually for six years. Nervous asthenia, melancholy, 
with hallucinations. This is a representative case. A 
gentleman in the prime of life. His profession an 
accepted warrant for uprightness and probity. A 
victim of neurasthenia, — nerve exhaustion. Worn and 
debilitated by pulpit and pastoral labors, he had 
expended more force than he could afford to spend. He 
sought to replenish his wasted energy in the retirement 
of his own study. His calling forbade the public use of 
intoxicants. He never entered. a saloon, and if wine 
was offered at social gatherings, he forced himself to 
refuse it. He was an ardent student, and in the silence 
of the long night hours, while his family slept, he was 
to be found in his lonely study. There, with his bottle 
and his books, his wearied nerves contested with his 
conscience, for the right to forget his cares, and invite his 
slumbers by the free use of the bottle. At first the 
conflict was severe ; there was no localized distress, and 
yet every nerve tendril seemed to throb and yearn for 
repose. A sort of moral mirage enveloped him, and 
his thoughts lost themselves in the mist. Then he 
emptied the bottle, and the sleep of intoxication put an 
end to thought. 



SOLITARY, MIDNIGHT INEBRIATES. 53 

The following clay brought with it a parched mouth, 
a dry tongue, headache, irresolute purpose, and remorse. 
Is it any wonder that seasons of melancholy sometimes 
come, to bow the spirit with forebodings of coming evil, 
and that countless spectres of unreal things should float 
in the atmosphere of such a mind ? I can scarcely con- 
ceive of a state more miserable. Secret intoxication, 
lasting only for a night, to be followed in the morning, 
by the semblance of a normal life, visiting and counsel- 
ing, holding meetings, and conducting public worship, 
and all the while, behind the invisible mask, the memory 
of the closet debauch, stinging the spirit, with no other 
relief than in its repetition. Carrying within him the 
image of the scene he cannot forget, and yet wishing 
the hours to hasten on, that he may cast aside the mask, 
and behind the locked door, the bottle, the drink, and 
the narcotism, may rest him again for another day. 

This is no fancy sketch. Many an eye may rest on 
this page that has witnessed similar struggles, and fallen 
into the same forgetfulness. There are many such men, 
men of learning, integrity and piety. They are solitary, 
night inebriates, who avoid alike the glittering saloon 
and the giddy circles of social revelry, but who almost 
nightly retire to their secluded Gethsemanes, where they 
may commune w r ith the profoundest needs of their 
nature, and know not how else to supply and satisfy 
them. The world does not know their frailty, much 
less, the means they take for relief. To this class belong 
orators, and literary men, men of genius. Such cases 
are apt to terminate in some form of chronic alcoholism, 



54 ALCOHOLIC INEBRIETY. 

the evidences of which become apparent in attacks of 
local or general paralysis, or some similar neurotic or 
brain disorder. Dr. David Skae, an eminent alienist of 
Great Britain, and physician to the Royal Edinburg 
Asylum, says : that u there is the regular-drunkard who 
keeps sober during the day and gets drunk at night, and 
attends to his business regularly during the day. Such 
men carry on for many years, without injury to them- 
selves or others. I have known one case, where a gen- 
tleman was carried to bed drunk every night for fifty 
years, and yet he made a large fortune, and was in the 
market every morning, attending to his business." * * * 
" Many of them, I know, live to a great age ; I have 
known men upwards of eighty, who have been drunk- 
ards of that kind." 

The craving for liquor in these cases is different from 
the craving in some other forms of the disease. There 
are no long intervals of sobriety which are suddenly 
interrupted by an unexpected outbreak of a passion for 
drink. The craving takes the form of habit, more like 
that for a night meal after a long interval of privation 
of food, but it is nevertheless positive in character, and 
reg\ilar as to time of occurrence. That they sometimes 
terminate in paralysis, is illustrated by the following: — 

Case No. 69. Aged 73. Retired gentleman. Has 
been drinking regularly for forty years. Loss of memory, 
partial paralysis, etc. Such is the abstract of the entry 
made on his coming under my care. Forty years' 
drinking, but not often what is called drunk. A soli- 
tary night drinker. Attended to business during the day, 



SOLITARY, MIDXIGHT INEBRIATES, 00 

took part in public affairs, was reported to be a man of 
experience and judgment, and well esteemed as a good 
citizen. One feature of l>is drinking was that his pota- 
tions were not always excessive, and failing to sleep 
soundly, he would rise from his bed, appear on the street 
during the night, call at the houses of friends, and at 
accustomed business places, and rinding them closed, 
would return, without confusion or embarrassment, to his 
home, in a sort of semi-conscious, bewildered state, go 
to his bed, and be refreshed by sleep. With the return 
of the morning, however, he failed to recall any of the 
transactions of the previous night. Following this 
mode of life, in a short time, partial paralysis succeeded 
the loss of memory, and his motorial functions being on 
this account interfered with, the night walks were dis- 
continued, and exercise of any kind becoming difficult, 
he slowly yielded to the progress of his paretic disorder, 
and "death from dementia" was the final verdict of his 
medical attendant. 

Solitary or secret drinkers are to be found in almost 
every community. Some of them will never come to 
the surface. Perhaps a majority of them are able to 
conceal their habit, and it may never be known. They 
are men generally of mark and of work — -intellectual 
work — men of genius often, men whose habits, aside 
from the use of intoxicants, incline them to late hours, 
to study, and to seclusion. And we know not how 
many effusions of poetic genius, or how many discov- 
eries in the realm of science or philosophy, have been 
evolved from amid the fumes of the bowl. For it is cer- 



56 ALCOHOLIC INEBRIETY. 

tainly true, that the impression made upon the human con- 
stitution by such beverages, may both hinder and quicken 
brain force, so, that under its influence a certain degree of 
brilliancy may be imparted to the mental operations of 
some persons, while in others, the consequence of its u? e 
may be confusion and incoherency. In these secret 
night-drinkers, the craving which constitutes the morbid 
state does not manifest itself, as it does in persons of 
different temperament and habit. It is a neurasthenia, 
but it is associated with the idea of privacy, secresy, 
concealment. Drinking is not spoken of. It is regarded 
as a practice not to be made known. For such a person 
to visit a public saloon and drink, would be as unusual 
and repulsive to the moral sense, as in the case of a 
temperance advocate. It does however, happen that 
there may be a divergence of this impulse into other 
lines. Like a current of electricity that follows a single 
wire to a point where the wire is connected with several 
others, the current will separate into many, and flow in 
each. So a certain constitution may, up to a certain 
point, be direct in its leadings, and then, from age, 
difference in condition or circumstance, exhibit other 
tastes and follow other pursuits, in which case the crav- 
ing will be modified as to time of appearance, and the 
character of its demands. A most interesting example 
of this sort may be exhibited in the following : — 

Case No. 205. Age 26. Student. Habitual use 
of alcoholics, opium and hasheesh. I found this young 
man cultured, refined in taste and tendencies when 
sober, fond of music, pictures, books, and especially of 



SOLITARY, MIDNIGHT INEBRIATES. 57 

the ancient classic authors, but when intoxicated, brutish, 
violent and dangerous. He speaks thus of himself: "i 
was born with a peculiar temperament; while in my 
cradle, was peevish, cross and troublesome, and have 
been a trouble to others ever since." As a youth, he 
was timid, retired, almost to solitariness. He says 
again : " As the 'teens gathered upon me I struggled 
with my timid nature, and sought the society of virtue 
and love. I was a big infant, timid, suspicious and 
fretful, always wanting to realize something that was 
not within my reach, but in the society in w T hich I 
mingled I found not the solace that my nature yearned 
for." At college he was an isolated student. The 
sports which others enjoyed, he could not participate in; 
he learned to drink at Princeton, and w T as dismissed. 
He tried again at Cambridge, but with the same result. 
At last he became his own tutor,' in the silence and seclu- 
sion of his own rural home, where, too, he became a 
solitary inebriate. While under my observation this 
youth presented for my study the most extraordinary 
combination of gifts and qualities. He was a specimen 
of enigmatized humanity, such as I had not before seen. 
Problems, riddles, concealments, obscurities, wit, culture, 
cheerfulness and sadness, obstinacy, refinement and rude- 
ness, were all joined and jointed in a grouping that was 
to me most novel, and at the same time the most engaging. 
A family history was behind it all, covering generations, 
in which eccentricities w r ere a marked feature. To any 
one who was patient enough to study him, and to whom 
he would give his confidence, he kaleidoscoped himself 
5 



58 ALCOHOLIC INEBRIETY. 

hoar by hour/ presenting under various circumstances a 
jjiost instructive psychological study. It is not surpris- 
ing that such an one should invade the whole field of 
artificial stimuli in search of satisfying potions, and he 
tried most of them. Whisky at first aroused the most 
dangerous qualities of his nature, -and under its influ- 
ence, the quiet student and patient artist, was transformed 
into an excited madman, finally breaking away from his 
midnight solitude and roving abroad, unconsciously 
displaying ffimself to his neighbors. Recovering, and 
being told what had happened during his debauch, a 
turn was taken suddenly, and a new character appeared. 
To avoid alarming those about him, and disgracing 
himself in his own eyes, he determined to resort to 
opium, and thus he soliloquized: " Opium may bring 
a solace to a spirit wounded by the unremem- 
bered story of outrage and evil. It may bring 
rest to tired muscles and nerves. It may soften 
the passions, and subdue the misguided will. It cer ; 
tainly will bring repose and dreaminess to a jaded and 
w r ounded spirit. But then the effect may soon pass away, 
and leave the unhealed system to itself again. Thus 
doubting and fearing, the experiment was made, and for 
a time persisted in, but did not prove satisfactory, and 
again he soliloquized as follows : Opium does not 
satisfy. I am the same restless and untamed nature as 
before. It does not intensify any emotion, or thought, or 
desire. It simply soothes, dreams, and vanishes. It 
lacks positiveness and certainty. It will not do. 

Now hasheesh is to be tried. It was taken freely, for 



SOLITARY, MIDNIGHT INEBRIATES. 59 

he could not bear long intervals of sobriety. The 
private drinking dispensation had passed with him. 
He was out on the high road of a reckless and lawless 
life, and yet every time he reviewed the story that was 
told him of his conduct during a debauch, the sensitive 
and refined element of his nature would assert itself, 
and an impulsive effort to change his course would be 
made. Now, he was in the fairy land of the hemp- 
eater. A singular sense of strangeness seemed to pos- 
sess him and every object that came before him. Every- 
thing was tinged with novelty. Voices were strange. 
Distances were magnified. Sounds were unreal. Melody 
arose from his piano as a vapor that vanished in the 
distance, and lingered only like a far off murmur. 
Nothing was satisfactory, and he awoke from his half 
slumber, bewildered and distressed. Another sober in- 
terval, and all that he could learn from others, and all 
that he recalled himself of the Opium and Hasheesh 
experiences were studied and carefully analyzed. One 
was soothing, swaying dreaminess. The other was a 
puzzling, awkward sense of actual things, being unreal. 
Everything was perverted and no repose came. Thus 
were comparisons made with the alcoholic intoxication, 
but none of them compensated the disturbed nature 
with a satisfactory return. Nothing paid but the clead- 
drunk condition which alcohol creates. With all its 
unconscious profanity and brutality, it was the most 
satisfactory. It brought profound sleep. Absolute for- 
getfulness of self, and everybody and everything. It 
satisfied to the full the ungovernable physical craving, 



60 ALCOHOLIC INEBRIETY. 

and terminated the paroxysm with longer intervals of 
a sober selfhood, than could be obtained by using any 
other intoxicant. 

Recovery was the sequel of this case. He now lives 
a quiet, retired life, married, devoted to study, and 
surrounded with the refining influences of culture and 
taste. 

Another form of intoxication whose symptomatology 
is unusual, is accompanied with a propensity to thiev- 
ing, to drinking on certain days, and to commit 
violence, and frequently violence of a specific kind. 



INEBRIATES WITH TENDENCIES TO SPE- 
CIAL VICES, AND TO SPECIFIC 
FORMS OF VIOLENCE. 

Some are exceedingly economical during a carouse, 
and so manage to satisfy their desire for drink through, 
the pockets of friends or fellow-drinkers, and only 
drink when they are invited. On the other hand, a 
lavish wastefulness characterizes some, and they are ever 
ready to treat, not only friends, but any who may be 
near at hand. These peculiarities are not accidental, 
but uniform in the individuals possessing them. Some 
drink only on Saturdays, and oftener after sundown on 
that day, sleep off the fit, go to church the next day, 
and are sober the remainder of the week. Some have 
particular days on which they become debauched, and 
do not indulge at other times. Public holidays ; private 



TENDENCIES TO SPECIAL VICES. 61 

anniversaries, as of marriage, or the birth of a child, 
are occasions that are thus celebrated. I have known 
the proprietor of an extensive mercantile house, who, 
for eleven months and two weeks of each year, applied 
himself closely to business, in which he was successful, 
who, on the same day of the same month in each year, 
joined himself to a man of low estate, with whom he 
could not be on terms of social freedom when at home 
and sober, and occupied two w T eeks on a fishing excursion. 
Before the arrival of the appointed day he arranged 
his business for a fortnight's absence, drew checks to 
meet the w T ants of his home and his store, made appoint- 
ments for the day of his return, and equipped himself 
to meet his companion, who was to serve as his guide 
and care-taker. With a boat on the bay, or river, a 
tent for the shore, and an abundant supply of " creature 
comforts," they commenced at the appointed time. 
Fishing by daylight, and tenting at night were to be 
continued during the allotted vacation, under the follow- 
ing agreement : — 

For a dozen consecutive nights, the merchant was to 
be supplied with whisky in quantities sufficient to pro- 
duce intoxication, and his companion was to keep sober, 
in order to protect their property and themselves, and 
to do all the offices of cook and " maid of all work." 
The last day and night, were to be spent in " sobering 
up," and getting things in order for a return to the 
duties of the head of a family, and the head of a mer- 
cantile house. At no other time in the year did this 
gentleman indulge in strong drink, and it was the only 



62 ALCOHOLIC INEBRIETY. 

specified time when the fisherman was under bonds to 
keep sober. Before leaving home, an estimate was made 
of the exact quantity of spirits needed for the whole 
time, and no more procured. So that the fisherman was 
obliged to be exact in portioning hisrations ; and a check 
was thus placed upon himself. 

Dr. Alexander Peddie, of Edinburg, who has con- 
tributed valuable treasures to the literature of inebriety, 
says : " At the prison of Perth, one woman was com- 
mitted one hundred and thirty-seven (137) times, for 
being drunk, and when drunk, her invariable practice 
was to smash windows. 

"A man, when drunk, stole nothing but Bibles, for 
which offence he was transported. He was a soldier, 
and had been wounded in the head. 

"Another stole nothing but spades ; another, nothing 
but shawls; another, nothing but shoes; and a man was 
transported for stealing tubs, seven different times; when- 
ever he stole, he was, with one known exception, always* 
guilty of tub-stealing." 

That stealing should be associated with intemperate 
drinking is not remarkable nor unusual, but the unifor- 
mity of the act under the influence of strong drink, is 
exemplified by a sufficient number of cases to give 
coherence to the theory, that there is a disease of the 
brain in such persons, on which but little light is thrown 
by our present knowledge of cerebral pathology. We 
are not informed whether these persons were conscious 
of their stealing at the time of the act, or whether the 
act was recalled by the memory, on a return to sobriety. 



TENDENCIES TO SPECIAL VICES. 63 

Like many other unsolved problems that are continually 
presenting themselves in the etiological study of such 
cases, their complete and satisfactory solution must be 
left to the methods of discovery and analysis that await 
us in the near future. 

Dr. Crothers, of Hartford, and the late Dr. Beard, of 
New York, have recently made interesting inquiries into 
the Trance State in inebriety, and in reviewing my notes 
of cases treated a decade and more since, I find examples 
that are illustrative of the same variety of cerebral 
automatism, and I select the following in confirmation 
of their theory : — 

Case No. 29. A sprightly, attractive, good natured 
youth, fond of society and of sport, and especially of 
fast driving and trading in horses, of which his father 
and brothers owned quite a number. Residing tempo- 
rarily, fourteen miles from a populous city, and visiting 
the city on parole for a day, he found it very easy to 
forget his obligation by indulging in drink. 

When his intoxication had reached a certain point, 
which can neither be defined nor understood, the usual 
impulse to seek the stable, order a horse for a drive in 
the park, came upon him, and being a considerable dis- 
tance from his father's stable in the city, he deliberately 
unfastened a horse that was secured to a post on the 
sidewalk, mounted the vehicle and started for the four- 
teen miles' drive to his temporary home. He avoided 
the carts, drays, carriages and cars that crowded the 
busy thoroughfares of the city, crossed bridges, passed 
turnpike gates, and in due time arrived without injury 



64 ALCOHOLIC INEBRIETY. 

or mishap at Iiis destination. Fastening the horse at 
the proper place, on arrival, and reporting himself in the 
house, he could give no account of his strange proceeding. 
He knew he was at home, recognized familiar faces, 
retired to his room, and on the following morning was 
as much surprised as any one, with the fact that he had 
driven home instead of taking the train, for which he 
had a return ticket in his pocket. An advertisement 
for the missing horse was found in the morning paper, 
and the young man, with an attendant, promptly 
returned the animal to an anxious physician, who was 
visiting a patient at the time of the disappearance. Re- 
grets, explanations and apologies were pronounced in 
due order, of course, with an offer to make restitution 
for the delay and inconvenience, but the doctor, appre- 
ciating the situation, and grateful that his favorite mare 
was not damaged, dismissed the youth with wholesome 
advice. 

Dr. Crothers mentions a case somewhat analogous, the 
man being " repeatedly convicted of horse stealing," and 
who was punished by imprisonment, and died of pulmo- 
nary consumption during his incarceration. His mother 
was insane, and his father " a weak-minded man." In 
my case I could trace no insanity or phthisis in the 
immediate family. Such cases are full of interest in a 
medico-legal, as well as in a strictly scientific sense. 
The time is at hand, when they will come oftener to the 
surface, and furnish material for study and discovery. 
These transcoidal states are, however, not new. They 
have not been observed as they might have been, for the 



TENDENCIES TO SPECIAL VICES, 65 

reason that they have simply been grouped wit'h other 
and more important symptoms, which so frequently 
occur in fevers, — in hysteria and other of the neuroses, and 
in which we are accustomed to regard such automatic 
phenomena as indicative of sympathetic or functional, 
rather than of structural disorder. Now that they are 
being dislocated from their groupings, and studied 
specifically, they stand out with a prominence that is 
significant of more certain cerebral disturbance. What 
the natural position of these phenomena is, may be inex- 
plicable, in the same way that all the phenomena of life 
are mysterious, and all attempts to trace them to their ulti- 
mate cause, have been unsatisfying. And yet admitting 
this as true, we are privileged to be at large in the vast 
field of research, from which may yet be gleaned more posi- 
tive truth. Enough, certainly, is apparent to the most 
superficial and unscientific observer, to warrant the belief 
that all such cases as have been described under the 
head of disease, are beyond the reach of what are called 
moral means. And certainly they are far removed from 
the domain of law. They must be relegated to the realm of 
science; and reformers, and advocates of temperance espe- 
cially, can never reach the true level of the subject they 
have in hand, till pledges, resolves and legal enactments, as 
cures or preventives of inebriety, are abandoned, and 
the intelligence of those who move in this direction is 
cultured by a knowledge of the true causation, and career 
of drunkenness. Some of the most prominent and 
frequent immediate causes of intemperance, are never 
referred to in the popular literature of the subject, and 



66 ALCOHOLIC INEBRIETY. 

certain complications of other morbid states which con- 
tribute largely to hinder recovery, are always overlooked 
by authors and speakers ; and until the researches of a few 
pioneer thinkers have made them prominent, the facts 
connected with the trance or automatic condition, of 
which alcohol is the chief factor, would still linger 
among the things doubtful ami obscure. The following 
remarks by Dr. Crothers are so fresh and original, as 
bearing upon this phase of the subject, that I cannot 
forbear quoting them : — 

" The gospel temperance meetings, where the excite- 
ment is intense, are excellent places to study this 
trance state. Men in different stages of alcoholic excess, 
will come forward and sign the pledge, and manifest 
great earnestness, and yet next morning be utterly 
oblivious to everything done. I have seen many ine- 
briates' just this side of stupor and muscular paralysis, 
be attracted to these gospel meetings by some means, 
and become the most enthusiastic men, sign the pledge, 
and describe their past degradation with evident satis- 
faction, and close with the wildest assertions and prom- 
ises for the future." *--**■« Thoughtful men 
often wondered why the same persons, who were so 
enthusiastic, did not appear more than once or twice at 
these gatherings. On inquiry it was found they had 
fallen, or gone back, when in reality this was a trance 
state, from which, on recovering, they did not return, 
because they could not realize the position which they 
had taken. A United States Senator, who was an ine- 
briate, appeared at one of these meetings, and made a 



TENDENCIES TO SPECIAL VICES. 67 

solemn pledge not to drink again; the next day he* 
denied it, and never believed or acknowledged that it 
was true." 

Doubtless there are some men, who, on discovering 
what they have done, make an honest effort to keep 
their pledge and lead a new life. Others, finding them- 
selves in a false position, for very shame, avoid all efforts 
of the kind afterward. 

u In one case, a man who had signed the pledge was 
for many weeks both speaking and drinking, creating 
intense excitement everywhere, then recovered, with no 
connected memory of it." * * * "It may be stated 
as a fact, that in all cases where religious emotion is 
constantly appealed to as an element of cure, the patient 
is on the border of the trance state, and, furthermore, 
any system of treatment which depends exclusively on 
the religious element, cannot build up healthy tissue or 
restore defective brain force."* 

I think we are indebted to Dr. Crothers for being 
the first writer on this subject, to give such prominence 
to the trance view of it, and though his views, as just 
quoted, may not be accepted as sound by many, they 
are nevertheless worthy of careful thought, by all who 
desire the whole truth. 

Among the exciting causes which are not even men- 
tioned in the popular literature of the subject, are 
injuries, chiefly of the head; and I shall now present 
some important facts, taken from a " Statistical Report 

^See "Trance State in Inebriety, in its Medicolegal Rela- 
tions," by T. D. Crothers, m.d., 1882. 



68 ALCOHOLIC INEBRIETY. 

of two hundred and fifty-two cases of inebriety, etc.," 
by my late esteemed friend, Dr. Lewis D. Mason, of 
Brooklyn, and for the purpose of giving such cases a 
definite place in the classification, I shall designate the 
variety referred to, as 

TRAUMATIC INEBRIETY. 

Dr. Mason had ample opportunity for the study of 
this subject in the wards of the " Inebriates' Home," at 
Fort Hamilton, Long Island, and to his carefulness of 
observation, added to the cautiousness of his nature, we 
are indebted for the lucid and forcible classification he 
has given in his " Statistical Report," etc. Under the 
heading, " Exciting Causes," the Doctor places first on 
the list, " Head Injuries." "At least one in seven of 
the 252 cases (36) became inebriates from blows on the 
head." Mark the expression, "became inebriates." 
They were not so before the injuries were received, but 
because of the injuries, though most of them had previ- 
viously used alcoholics in moderation ; 12 were fractures 
of the skull; in four there was loss of bone; 22 had 
concussion; 27 of the 36 became habitual, and the 
remainder periodical dipsomaniacs. The Doctor remarks 
further, that other diseases or injuries, such as are liable 
to produce disorder of the cerebro-spinal axis, may either act 
as exciting causes of inebriety, or tend to protract it. A case 
is mentioned in which periodical dipsomania was associ- 
ated with stricture, which, on being divided and cured, 
resulted in removing entirely the attacks of periodical 



TRAUMATIC INEBRIETY. » 69 

drinking. Two other cases are mentioned, one of tape- 
worm, and one of necrosis of the bone of the leg, which 
being cured, "the attacks of dipsomania were not re- 
peated." Such examples of reflex irritation are quite 
commonly observed, as connected with other diseases, 
and as long as inebriety was excluded from the domain 
of pathology, and not considered as a disease, such remote 
influences were not supposed to affect the cerebral func- 
tions in connection with inebriation. Among the com- 
plications usually attending inebriety, there is no more 
common disorder than pulmonary consumption. In the 
family history, insanity, epilepsy and phthisis form a 
triple chain, the existence of which may be traced 
through several generations. 

It is remarkable also, that among the complications 
attending inebriety, there is a variety of surgical troubles, 
as fractures, concussions, shot wounds, hernias, etc., 
which contribute freely of material to the tragic history 
of many such persons, and which are so conspicuous in 
retarding recovery, in many cases. 

The following additional testimony in support of the 
doctrine of disease, is offered from the Blue Books of 
the House of Commons, which, not being accessible to 
most readers, is all the more valuable : — 

Dr. Robert Boyd, f.r.c.p., of London, and Physician 
to the Marylebone Infirmary and Somerset County 
Lunatic Asylum, says : — 

" Intemperance is the outcome of cerebral disease." 



70 ALCOHOLIC IXEBKIETY. 

* * * " Intemperate habits inay have been induced by 
cerebral disease." 

" Of sixty-eight cases examined, which died in the 
Somerset Lunatic Asylum, the majority had disease of 
the brain, prior to their continuous habits of drink" 

" Persons of an irritable frame, and a nervous excita- 
bility, are generally more prone to fly to stimulants than 
others." * * * "In a great many cases symptoms of 
insanity precede the drinking, but I should think, in 
the majority of cases, it is the reverse." 

Mr. William White, Surgeon and Coroner for Dublin, 
says : — 

" When a man is apparently relieved from the direct 
effects of drinking, there remains the craving, which he 
cannot account for, and which he cannot control." 

" Habitual drunkards have the desire themselves to 
refrain from it, and they make ineffectual efforts to 
abandon the drink; but the craving comes on, which 
they cannot resist." 

Dr. J. Critchton Browne, the Lord Chancellor's Vis- 
itor of Lunatics for England, says : — 

" Dipsomania consists of an irresistible craving for 
alcoholic stimulants, occurring very frequently periodi- 
cally, with a constant liability to periodical exacerbations , 
when the craving becomes altogether uncontrollable. I 
have known it produced by injuries to the head, in per- 
fectly sober and sedate men." 

" If the drunkard is predisposed to nervous disease, 
or has any tendency to insanity, he inevitably becomes a 
dipsomaniac. If he has a strong nervous constitution, 



TRAUMATIC INEBRIETY. 71 

he may resist the poison for many years, without his 
mind being permanently affected." 

Dr. Alexander Peddie, f.r.c.p., of Edinburg, says : — 

"They are governed by an imperious impulse which 
they are utterly unable to resist" 

" He (the inebriate) is a slave of a passion from which 
he cannot free himself, struggle however hard he may." 

" I consider it greatly in the nature of an internal 
disease." 

" I know it to be a fact that many children who have 
been brought up without the use of alcohol, either in 
the way of nutriment or medicine, have shown the 
tendency to drink before they had any opportunity of 
learning the habit." 

Dr. Francis Edmund Austie, Lecturer on Medicine 
at the .Westminster Hospital, London, says :— 

" Dipsomania is a disease which comes upon men at 
intervals, who are otherwise not inclined to drink at all." 

(t Periodical or paroxysmal drinkers have a great 
horror of drunkenness, in -their sober moments. Com- 
pared with any other class of drunkards, they are far 
less blunted in their moral sense." 

Dr. Arthur Mitchell, Commissioner in Lunacy for 
Scotland, says : — 

"Dipsomania occupies a peculiar relation to drinking, 
being sometimes the cause and sometimes the product 
of it," 

Mr. Balfour Browne, Barrister at Law, in London, 
and author of a work on " Medical Jurisprudence," 
says : — 



72 ALCOHOLIC INEBRIETY. 



a * 



'I believe that the dipsomaniac may not have the 
power of refraining from stimulants." 

Dr. Forbes Winslow, of London, author of "The 
Brain and the Mind," etc., says : — 

"In the majority of cases of habitual drunkenness, 
there is associated with it a disordered state of the brain 
which you do not cure. There is a disordered appetite 
which you do not eradicate. Although you keep the 
patient from drink, the craving for it is sure to return. 
There is no class of affections which, viewing them as 
mental affections, are so liable to relapse, as drunken- 



ness." 



Dr. David Skae, Physician to the Royal Edinburg 
Asylum, says :— 

" Dipsomaniacs lose all control over themselves, and 
drink to any extent possible. In fact, they will drink 
anything they will get hold of, and if they cannot get 
spirits, they will drink hair-wash, or anything of the 
kind. I have known a lady to drink shoe-blacking 
and turpentine. These cases are mostly hereditary. 
They are very often caused by disease, by blows on the 
head, sometimes by hemorrhage, sometimes by disease 
of the brain. All these cases I mention to show that 
this is really a disease, and not mere cases of drunken- 



ness." 



Dr. Robert Dewitt, of London, says : — 
" The habit of secret drinking is not amenable to 
moral and religious influences ; it defies them. I have 
known many instances of women, amiable, respectable, 



TRAUMATIC INEBRIETY. 73 

and preeminently religious, who nevertheless were the 
victims of this habit, from physical or moral causes." 

" Many of these persons suffer originally from dis- 
ease, from a peculiar state of the nervous system, or 
from some insatiable thirst for these drinks." 

Since the above has been in press, the author has 
received a very interesting and valuable letter from the 
Hon. Wm. S. Peirce, of Philadelphia, from which, by 
his permission, the following extracts are taken : — 

The Judge says :— 

u Some years ago a gentleman with whom I was very 
intimate told me some of the secrets of his life. I 
knew that he drank, but at the time he did not appear 
to be in the slightest degree under the influence of 
liquor. A few days after I referred to the matter, and 
he appeared to be wholly unconscious that he had ever 
told me, and said, with evident surprise, 'Did I tell you 
that'?" 

" Another case was that of a member of the Philadel- 
phia Bar. He was an intelligent man, but much given 
to drink. He had some important business to attend to 
before a judicial officer, and fearing he would not be able 
to attend to it, he requested a legal friend to attend to it 
for him. His friend went at the appointed time, and 
found the lawyer insisting on taking charge of the case, 
but evidently incapable of doing so. His friend man- 
aged to take control. A few days after, the lawyer 
called on him to know the result of the case, and what 
had been done. He had no remembrance of having 



74 ALCOHOLIC INEBRIETY. 

been before the officer, and had no knowledge of what 
had occurred there." 

" Another case was that of a man who was convicted 
before me of stealing a horse and carriage. He had 
been drinking, but was not so much under the influence 
of liquor as not to appear to act intelligently. On the 
witness stand he testified he knew nothing of what had 
occurred from the time he began drinking till he found 
himself in the cell at the station house the next morn- 
ing." 

" Another case was that of a young man, about eighteen 
years of age, who was convicted of murder in the second 
degree before me. He was unused to drink, but went 
to a barn-raising and drank some cider. After that he 
went to a saloon and took a single drink of liquor, gin, 
I think. He had a pistol, and went roaming through 
the streets, apparently without purpose. He saw another 
young man standing against a fence, and without quarrel 
or provocation, deliberately shot and killed him. When, 
he recovered from his condition, he w T as wholly uncon- 
scious of what had occurred, and did not seem to be 
drunk when these events took place." 

These are typical cases, illustrative of the same con- 
dition as some of those quoted by others, and are im- 
portant, as confirming, from a judicial standpoint, what 
has been noticed by physicians ; and it seems to me that 
such cases, coming frequently before the legal mind, 
must eventuate in a modified jurisprudence, that will 
eventually secure a larger share of justice to a deluded 
portion of the race. 



HEREDITARY INEBRIATES. tb 

Judge Peirce very wisely says, in relation to them : — 
"I am very much inclined to think there was some- 
think like insanity in these cases, differing from the 
ordinary and usual effects of drunkenness." 



HEREDITARY INEBRIATES. 

There is no research within the scope of biology that is 
more attractive and instructive in its bearing upon ine- 
briety than what is called heredity. I shall offer testi- 
mony to show how direct is the apparent transmission 
from parent to child ; and yet the term heredity should 
not be restricted in its meaning to this single form of 
transmission only, for it is equally true that intemper- 
ance crops out in some families ; w T here there has been no 
previous lodgment of the taint, but where other disor- 
ders have been active, from which inebriety is simply a 
deviation from the direct line, and is an evidence of the 
beginning of the alcoholic diathesis. That under the 
operation of the same law it has its termination also will 
be shown, for the law of heredity recognizes periods of 
limitation, as a necessity for the continuance of the race. 
If it was not for such a law^ and the degenerative processes 
were to be continuous, without deviation or exhaustion, the 
reproductive powers would sooner or later terminate, 
and the race become extinct. It must be borne in mind, 
therefore, that the union or mingling of certain tempera- 
ments, or qualities, may be so incongruous and inharmo- 
nious, as to create for the first time in any family record, 



76 ALCOHOLIC INEBRIETY. 

the starting point of disease. The links of insanity, 
epilepsy and inebriety, frequently alternate in the same 
historic chain, while pulmonary consumption, perhaps 
as frequently as any other disease, seems to lay the 
foundation for other morbid phenomena, that are mani- 
fested in the form of neurotic disorders. The likeness 
of progenitors may be developed sparingly or otherwise, 
and yet their completeness depend largely upon environ- 
ment of the individual, and largely, too, upon training 
and culture. As a defective organ may, by use or disuse, 
be improved or injured, so may any impulse, appetite or 
craving, when it becomes manifest, be measurably sub- 
dued or stimulated by exercise and training. The 
discipline of organ or function by environment, is of 
itself, a study that should command the earnest attention, 
especially of all those whose structure is not in harmony 
with external surroundings. Not only is there transmis- 
sion, but transmutation of disease, by heredity. Inebri- 
ety may descend as inebriety, but it is just as likely to 
change the form of its appearance into insanity, or other 
allied morbid manifestation. 

Chorea may descend as chorea, but it is just as 
likely to appear in the progeny as epilepsy, the chief 
difference in the two forms of disease, being in the fact 
that the convulsive movements in epilepsy are parox- 
ysmal, and in chorea they are not, while both may be 
identical in pathology. As water is changed into ice, 
so one disease may be transmuted into another form, and 
be known by a distinct name, at the same time possess- 
ing the same original qualities. 



HEREDITARY INEBRIATES. 77 

Amid the constantly varying and complicated dangers 
that beset the path of human life, and which constitute 
the environment of human beings, we should not expect 
completeness in the equally complex co-relations of the 
human body, which is so influenced by such surround- 
ings. Taking these extrinsic factors of disorder into 
account, with the defective vital processes of nutrition, 
and other functional operations, and placing them in 
conjunction with the toxic vestiges of previous maladies, 
and it is not difficult to apprehend how inherent morbid 
predispositions may be aroused, and made to declare 
themselves with a potency that establishes their claim to 
inherited taint. 

Dr. ¥m. C. Wey, of Elmira, New York, thus forcibly 
presents the case : — 

" It is well known, that in the searching review of 
the history of certain families from a fixed starting 
point, through lineal and collateral branches, no evidence 
of inebriety cau be found. 

"Men and women who represent this family, or 
more properly speaking, this idiosyncrasy, will, under all 
conditions and circumstances of bodily pain, mental 
suffering, pecuniary loss, affliction and disaster, preserve 
themselves from the consequences of inebriety. It is 
not through power of will, resolution, superior wisdom, 
foresight, caution or merit, that this exemption is mani- 
fested. Such persons could not become drunkards if 
they were so disposed. A certain moral and physical 
predestination, if I may thus use the word, protects 
them from the hazards of inebriety. No particular 



78 ALCOHOLIC XXEBKIETY. 

grace or excellence attaches to them for avoiding or 
escaping the consequences of alcoholic indulgence, 
although grace and excellence may often be assumed as 
the instrumentality by which they are spared the evils 
into which others appear so easily, and without let or 
hindrance, to fall."* 

The fact of exemption from inebriety in a family, 
however, does not exempt from other conditions which 
may result in inebriety. There may be insanity, chorea, 
epilepsy, hypochondria or other taints, which in the order 
of descent may take the form of drink craving, or even 
crime. In the stream that flows from one generation to 
another there are collateral feeders that are continually 
pouring in their morbid products, thus modifying the 
old and eliminating new morbific forces, which take on 
a variety of forms. 

From the report of Dr. Mason, already referred to, 
the family history is given of 161 of the 252 cases that 
he has so carefully tabulated, with the following result : 
Ninety-four had inebriate fathers, two mothers were 
inebriates, and both parents of four, grandparents and 
other relatives, 16. Insanity was traced to fifteen 
families, preceding inebriety. In some cases insanity 
and inebriety were present in the same family, showing 
the close and interchangeable relation of the two diseases 
to each other. There were also a number of cases of 
atavism. 

From the records of three hundred and sixty patients 

*Vide " Transactions of American Association for the Cure of 
Inebriates," 1871. 



HEREDITARY INEBRIATES. 79 

admitted to the New York State Inebriate Asylum up 
to a certain date, the late Dr. Dodge, then superintend- 
ent, reported " forty-two as the offspring of intemper- 
ate parents, or one in eight. Thirty-six had intemperate 
fathers, or one in ten. Six had intemperate mothers, 
or one in sixty. Nine had intemperate brothers and 
sisters, or one in forty. Sixty-six had intemperate 
ancestors, exclusive of parents, on paternal side thirty- 
six, or one in ten, on maternal side, thirty, or one in 
twelve." 

These are instructive figures, and yet in considering 
the heredity of inebriety, as in other diseases, it is pro- 
per to go beyond the direct line of special disease, and 
estimate the combination of temperaments which pro- 
duce an alcoholic diathesis, without any previous alco- 
holic history. 

As has already been said, it is by such union of quali- 
ties that the alcoholic craving is often established for 
the first time, and the master proclivity begins to assert 
itself, by what may be called a factitious heredity, that 
engrafts the new passion as an anomaly upon the family 
stock. 

But let us look for a moment to the other fact, — the 
great conservative fact of the law of hereditation, — that 
such propensity may not only begin anew, in any given 
family, but that it has its terminal point, as well. There 
is a natural tendency in our very life, to find a settled 
channel in which its forces may flow. So conscious are 
we, in the earlier periods of our adult life, of the exist- 
ence of strong and opposing passions and tendencies, 



80 ALCOHOLIC INEBBIETY. 

that we are apt to accept as an axiom, the common 
expression that " character is not formed till forty." 
Physical factors are all the time at work to develop 
and mature what is in, and of us, and it is not until 
maturity is reached, that a definite and uniform channel 
is wrought out and established. This age of maturity 
is not, and cannot be determined, according to a uniform 
rule, hut just as the sexual instinct has its time of be- 
ginning and ending, so other elements have a similar 
history. 

There comes a time in the course of one's life when 
the forces that have been engaged in structural repair 
and waste come, as it were, to a standstill, and consult 
together as to which shall be dominant in the future. 
Some organs of the body may be said to rest entirely, 
after a certain age ; rest by a cessation of function, and 
become atrophied also ; some, that do not rest absolutely, 
undergo a modification of functional activity. It is at 
this slack-water period, — at the middle of life, — when 
the molecular deposits in the organic structure, are 
different in quality than formerly, that we look for a 
different product. 

The craving for drink is not a craving of childhood. 
It does not usually declare itself till the demands on 
the nervous system begin to be exorbitant, and its 
terminal period comes with as much certainty as does 
its initial stage. That terminal period is the climacteric 
period. A dozen years ago, or more, I called attention 
to this thought, and urged those who had opportunity to 
observe, to note the period of life when the largest 



HEREDITARY INEBRIATES. 81 

number of reformations, or cures of inebriety, were 
accomplished, and stated then that I believed they would 
be found to be betw r een the ages of forty and fifty years.* 
Subsequent observation has confirmed this view. Between 
these ages, especially, do recoveries that are spontaneous 
occur. Statistics show that by far the greater number of 
persons first exhibit the alcoholic proclivity, between the 
ages of 15 and 25 ; and though I am unable to verify the 
statement by figures, I am convinced, that the allowance 
of twenty-five years of use will, in most cases, close the 
drinking career, either by the exhaustion of the desire, or 
by the fatal termination of the individual life. I think 
it will be found, also, that when inebriates have lived be- 
yond the middle period, so as to reach the three or four- 
score limit, the commencement of the drinking career 
was considerably later in life than the average period 
named. There is a good reason for increased longevity 
in cases of this sort. The later the propensity to drink 
develops itself, the nearer the person is, to the period 
when the constructive quality of the metamorphic pro- 
cesses, that are essential to living, gives place to the 
destructive, in which cases the use of alcohol is not 
only admissible, but desirable ; for if there is ever a 
period in human life, when alcoholic beverages are indi- 
cated, it is the period of senile degeneracy. 

I have referred to environment as an important force 

in the discipline of the functions of the human body, 

and now call attention to the importance of a practical 

adjustment of individuals with an inherited tendency to 

* Vide Proceedings, etc. 



82 ALCOHOLIC INEBRIETY. 

alcoholic indulgence, to the conditions and circumstances, 
amid which they find themselves placed. 

So far as regards the perpetuation of the human 
machine, and of all the organs and functions which are 
essential to its repair, nature has provided within the 
body itself, a sufficiency to reach the end intended — the 
ultimatum; but it must be remembered that the ultima- 
tum is not uniform; it differs as widely as human 
constitutions; but, as Dr. Dobell puts it, " there is also 
included within the functions of the organism a power 
of disposing of poisons, so as to avert their fatal effects, 
but this power is restricted by certain limits." * * 
" There is, then, no room to doubt that the same force 
which protects the organism against the undue influence 
of poisons generated within itself, protects it also against 
the poisons introduced from without."* * * 

{i Some of the force manifested in development, growth, 
maintenance and repair passes on into the germs of new 
cells and tissues, and again is passed on from the entire 
organism into the germs of a new generation." * * 
" It is reasonable, therefore, to conclude, and to affirm, if 
the existence of this force is recognized, with its power 
of succession and transference, that the constitution of 
the being possessing it, both in material and force, will 
be dependent on the conditions of the world in which it 
exists, subject to alterations, co-relative with that exter- 
nal world itself." Thus it is evident that the individual 
who is conscious of an inherited tendency to alcoholic 

* " Lectures on the Germs and Vestiges of Disease ;" by Horace 
Dobell, m. d. 



HEREDITARY INEBRIATES. 83 

excess, may do much to modify, if not to control its 
force, by placing himself under such conditions of liv- 
ing as will tend to increase his constitutional vigor in 
the direction in which it is most needed. A person 
coming into the world with a tendency to pulmonary 
consumption will, as soon as he knows it, begin to co- 
relate himself with the most favorable conditions of 
climate, occupation, etc., that the progress of the mor- 
bific element within him, may be arrested, if possible, 
and that the normal forces that are antagonistic to 
this manifestation of disease, may be strengthened. 

The same is true of other disorders. It is conspicu- 
ously true with the disease of inebriety. The fact of an 
inherited tendency to it, and the other fact, that by reason 
of such an inheritance, he is fortified with a potent 
stimulus to resistance, is an influential factor in the 
direction of health. It is lamentably true, however, that 
the popular view of this fact of inherited tendency, has 
influence in the opposite direction. The opponents of the 
doctrine of disease, insist that the knowledge of the fact 
of inheritance, is sufficient to arrest all effort at recovery, 
and is equivalent to abandoning the victim to a fatal 
doom. There is nothing more illogical or irrational in 
the entire field of polemics, as related to this subject, 
than the assertion so commonly made by reformers, that 
the dogma of inheritance leads to fatalism and despair. 
It is the great conservative truth in relation to other 
physical conditions, which all men may avail themselves 
of, who are inheritors of any special predisposing morbid 
element. If they know of its existence, they are forti- 



84 ALCOHOLIC INEBRIETY. 

fied, by that very fact, with a weapon of resistance. 
They are on their guard. They fear to be overtaken 
without watchfulness, — and they watch. Knowledge of 
danger is the guardian power, on which they rely as the 
inspiration to effort, to harmonize surroundings with 
internal conditions, and thus avoid the risk consequent 
upon ignorance, or doubt. It is impossible even to 
approximate the number of inebriates by heredity, and 
those whose inebriety is due to external causes ; but 
I am satisfied that among the chief hindrances to recov- 
ery from a life of inebriation to a life of sobriety, is 
the false teaching of those, who overlook the aspect of 
disease, and limit their labors and appeals to the domain 
of morals and ethics. When society comes to learn that 
the cause of inebriety is primarily in the disturbed rela- 
tions between different organs, and functions of the 
human system, and especially, that children come into 
the world, bearing with them the vestiges of disorders 
that have lingered through one or more previous genera- 
tions, light will begin to reflect its brightness upon new 
and improved practical methods. When society comes 
to add to this fact of inheritance, the other fact, that by 
adapting the educational, social and hygienic surround- 
ings of the growing generation, to its physical necessities, 
much may be done to arrest or counteract the develop- 
ment of the craving for drink, additional lustre will be 
imparted to the recuperative and restorative measures, 
that will appear as new revelations to the advanced 
intelligence of such a period. 



HEREDITARY INEBRIATES. 85 

The following quotations from witnesses before the 
Habitual Drunkards' Committee, of the British House 
of Commons, confirm the doctrine of heredity. 

Dr. Francis Edmund Anstie, says — 

" The tendency to drink is a disease of the brain, which 
is inherited." 

"When drinking has been strong in the families of 
both parents, I think that it is a physical certainty that 
it will be traced in the children." 

" I believe if a man habitually took two or three 
times as much stimulant as is required for the physio- 
logical wants of his body, his children would inherit 
those affections." 

"I desire to be understood that my opinion, based upon 
the most recent physiological researches, is, that alcohol 
in moderate quantities is an exceedingly useful article of 
daily food, at any rate for large classes of the com- 
munity." 

Dr. J. Critchton Browne, of London, says— 

" I think that the hereditary tendency from drunken 
parents does not always manifest itself in insanity, but 
frequently in idiocy and crime." 

" I think that in about one-third of those cases of insan- 
ity which I found to be due to drunkenness, there was 
a hereditary tendency, as a cooperating cause with the 
drunkenness, creating the predisposition." 

Dr. Forbes Winslow, the distinguished teacher and 
author, says — 

In examining a list of criminals " there was a father 
a drunkard, a grandfather a drunkard, grandmother an 



86 ALCOHOLIC INEBRIETY. 

idiot, and in the whole line of that family there were 
drunkards, there were criminals, there were idiots ; all 
forms of vice were hereditarily transmitted." 

Dr. Alexander Peddie, of Edinburgh, says — 

" I believe the habitual drunkard inherits the pro- 
clivity from drunken parents, or an insanity from a 
constitutional insanity in his family, in which the most 
marked manifestation is a tendency to drink." 

" A lady of good education and good principles began 
to drink at the age of sixteen, died at the age of fifty- 
six, during which time she had many severe and pro- 
tracted fits of drinking, and at last drank herself to 
death. * * When under control, she was intelligent, 
active and industrious, making herself useful to others. 
Sometimes she employed herself as Bible-reader, and 
when in the country three years, under continued con- 
trol, she gave herself to geology and botany, and wrote 
most excellent letters from her retreat. Her father was 
an habitual drunkard, a grand aunt on her father's side 
was the same, and also a cousin on the father's side. On 
the mother's side, the mother was an habitual drunkard, 
a brother was also, another brother was insane, an aunt 
was an habitual drunkard, two nieces, daughters of the 
same were habitual drunkards, and some other members 
of these two families are said to have been affected 
in the same way." 

Dr. Robert Druitt, of London, author of a work on 
Surgery, says — 

u The condition which gives rise to intemperance is 
hereditary." 



HEREDITARY INEBRIATES. 87 

"In some families there is a nervous system of bad 
construction ; the members of those families are marked 
by enormous consumption of both food and drink, and 
at the same time by an enormous oxydation and waste. 
They are constantly in a state of chronic hunger and 
exhaustion." 

" The class that I appeal for are chiefly women of 
the upper classes, or men who are led to secret drinking 
for the relief of misery, bodily or mental." 

" They have frequently inherited a very feeble or 
a very excitable nervous system." * 

* * " When persons have imperfect brains, when 
they are eccentric and slightly subject to disease, that 
state is hereditary, and it will lead to drink." 

Dr. Charles Elam, m.r.c.p., in his remarkable vol- 
ume, "A Physician's Problems," presents some striking 
examples of transmitted tendency to intemperance, 
from which the following are taken : — 

"The habit of the parent, when inherited, does not 
appear in the child merely as a habit, but in most cases 
as an irresistible impulse, a disease." 

" This disease, known as dipsomania, is quite readily 
to be distinguished from ordinary intemperate habits ; 
it is characterized by a recent writer as ' an impulsive 
desire for stimulant drinks, uncontrollable by any 
motives that can be addressed to the reason or con- 
science, in which self-interest, self-esteem, friendship, 
love, religion, are appealed to in vain; in which the 



88 ALCOHOLIC INEBRIETY. 

passion for drink is the master passion, and subdues to 
itself every other desire and faculty of the soul/ " 

" The tendency to suicide is frequently , though by no 
means invariably, allied to the heritage of drunkenness." 
* * '" Four brothers inherited the passion for drink, 
which they all indulged to excess. The eldest drowned 
himself, the second hung himself, the third cut his 
throat with a razor, and the fourth threw himself out of 
an upper window" etc. 

Dr. John Nugent, Inspector General of Lunatics for 
Ireland, says : " I have a case of a gentleman of for- 
tune ; the father was insane, he had a brother ; one of 
the brothers took to drink and the other became insane 
without ever indulging in drink at all; so that the 
hereditary disposition showed itself in one by actual 
insanity, and in the other by drinking." 

INEBRIETY AND INSANITY-HOW 
RELATED. 

Nobody has yet solved the problem of insanity. No 
lexicographer has given it a definition that can be 
accepted as a rule of action. No scientist has expressed 
its meaning in language that the law recognizes as 
authority. No jurist has defined it in terms that science 
can comprehend. The reason is, that the eyes and 
understanding of law, are different from the eyes and 
understanding of science. And yet insanity, in its main 
features, is one and the same thing, and has been during 



INEBRIETY AND INSANITY — HOW RELATED. 89 

all time. Its pathology is unchanged, and its symptoms 
are alike, and have been, from age to age. The law can- 
not see it at all unless it does something. It must rave 
in open madness, or skulk beneath the cloud of speech- 
less melancholy. It must hurt or kill, it must steal or 
burn, or do some overt act, before the eyes of the law 
can even discover its existence. So, likewise, science, 
while it penetrates beneath the external and visible, and 
finds it lurking in mute disguise within the cunning 
network of the human frame, fails also to define it. 

Inebriety, on the other hand, has been visible and 
offensive, from generation to generation. It has obtruded 
itself upon society as a disturber of domestic and public 
peace, and all people have looked upon it, from all sides 
and with all kinds of eyes and understandings, and it has 
been described with a comparatively uniform exactness, 
though its true definition and nature have not until 
recently been known. The law has not penetrated the 
hidden places of our being, to seek out occult forces 
that impel an inharmonious nature to indulge in alco- 
holic excitants; and hence drunkenness, like insanity, 
must do something before the law can apprehend it. It 
must steal or burn, commit an assault, or in some way 
disturb the peace and safety of society, or the law cannot 
lay hands upon it. Science alone has been able to dis- 
cern the latent pathological state from which the drink 
craving comes, to command and control the being who 
is its victim. 

Insanity is a disease of the brain, some say, of the 
mind. Viewing the latter as a distinct entity, bu : t 



90 ALCOHOLIC INEBRIETY. 

avoiding in this place the discussion of the somatic and 
physiological theories of insanity, it will be assumed, as 
we know nothing of mind as an entity separate from 
the brain, that insanity is essentially and exclusively a 
brain disease. 

It is not so with inebriety. Insanity means mental 
unsoundness, in a general sense. In a more particular 
sense, deprivation of reason. Hence no one is insane, 
whose processes of intellection and ideation are regular 
and complete, and whose organs upon which such pro- 
cesses depend, are in good working order. Inebriety 
does not mean or imply mental unsoundness. Inebriates 
reason as logically and clearly as persons of the same 
degrees of culture, and with like opportunities, who are 
not inebriates. Their processes of intellection and idea- 
tion, when sober, are undisturbed. When poisoned by 
alcohol, they are like persons under the toxic influence 
of any specific disease which affects the brain, and for a 
time are off their poise, and become delirious, as in 
typhoid fever, or when the blood is poisoned, or in 
cerebral inflammations when the sensorium itself is 
assailed. 

Insane and inebriate persons may all be out of har- 
mony with their external relations, but from different 
causes, and under different conditions, and it is important 
that the distinction should be drawn ; the mental vision, 
the brain-perception of the insane, causes him to be 
athwart his circumstances and surroundings. He does 
not see things as they are. He does not comprehend 
himself, and he maintains his position with a persistency 



INEBRIETY AND INSANITY — HOW RELATED. 91 

that characterizes his disorder. The inebriate is out of 
harmony with his environments, only when he is ine- 
briated, for it is important to remember that an inebriate 
may but seldom be under the toxic power of alcohol, 
and when he is not, his relation to others and to the 
world about him is a normal relation. His disease is 
an irrepressible longing for the state of drunkenness ; 
not' so much for the liquor that produces intoxication; 
and he is just as much an inebriate, — diseased, — when he 
is able to control for the time his desire, as when he 
indulges. The indulgence may be regarded as the 
second stage in the manifestations of his disease. Until 
he yields his will, and gratifies his propensity, he is 
usually in an intellectually normal relation to his family 
and the community. The surrender of his volition, 
and with it, his judgment and his interest, is the first 
evidence of the overpowering mastery of his passion, 
which prostrates and beclouds his reason, until his debauch 
is accomplished. Then all his powers of mind re-assert 
themselves as before, and he is re-established in his 
domestic and civil relations. I do not say that the 
inebriate is well balanced. He is not. He is apt to be 
fickle, uncertain, liable to sudden departures, and all 
that ; but these are not insanity. They are not the pro- 
duct of impaired intellection or defective knowledge. 
He can say with the great master of poetry, Scott — 

" I have been hurry' d on by a strong impulse, 
Like to a bark that scuds before the storm, 
Till driv'n upon some strange and distant coast, 
Which pilot never dream' d of," 

When sober, he regrets what he did that was wrong 



92 ALCOHOLIC INEBRIETY, 

while under the influence of liquor, and is anxious often 
to make restitution. The insane, on the contrary, do not 
excuse themselves for offensive conduct. They think 
themselves right, and are self-justified. Their reason 
does not apprehend the enormity of evil doing, and 
their judgment is incapable of determining ethical 
questions which are intuitively discovered by intelligent 
inebriates. 

Inebriety being due to physical causes, the general 
belief is that what are termed " drunken fits" are induced 
voluntarily, and that the inebriate is therefore doubly 
to blame for any overt or irregular conduct ; to blame 
first, for drinking to excess, and next, for whatever may 
be the consequence of his excess. It is indeed true that 
the will, by nature and right, is the supreme arbiter of 
moral conduct, but it is equally true, that it is sometimes 
overpowered and subdued by the drink-craving, just as we 
are overcome and subdued by extreme pain, or exhaustion, 
or shock. We suffer the pangs of disease, or serious 
accident, and it is but seldom that even the most stalwart 
frame, or the grandest intellect, can, by the mere behest 
of the will, overcome or modify physical suffering, or 
hold back the groans and tears, which are the normal 
expression of pain. 

A man is in extreme danger, — shipwrecked at sea. He 
is clinging to a spar in mid-ocean, exhausted by anxiety, 
hunger and thirst, with no means of relief in sight, 
nor scarcely any to be hoped for. He has no pain, 
but he thirsts for water. He knows if he drinks the 
salt — sea — water that his thirst will be intensified, and 



INEBRIETY AND INSANITY — HOW RELATED. 93 

lie will be made more miserable. But the demand 
of his nature is for liquids. The fluids of his body are 
diminished, almost exhausted, his tongue is parched, his 
throat dry, and he must have water. He yields to the 
craving, and as a dog laps water from the wayside pool, 
so he, with his parched tongue, laps the waves as they 
pass, thus increasing his agony and danger. He does it 
because he must. His will is powerless. His condition 
is analogous to that of the dipsomaniac. The demand 
is physical, the suffering is not that of pain, but of an 
unsatisfied yearning for relief. It may be a starved or 
a diseased appetite. In either case the suffering is 
intense. It must be relieved at any cost. In the same 
sense, insanity is the result of voluntary action. Many 
an unhappy victim of a morbid propensity, who scarcely 
knows what it is, or from whence it comes, or how to 
describe, and much less to define it, is afloat on the sea 
of worldly pursuits, and human duties, clinging to his 
manhood, and to the consciousness of his inalienable 
title to a place in the family of men ; and yet misun- 
derstood by others, and failing to comprehend his exact 
relation to them. He seeks the counsel of his physi- 
cian, who, apprehending the situation, and foreseeing the 
danger, interposes restrictions, and outlines a course of 
living which he must observe, or fall into the pit which 
his grandparents, or some other venerable representa- 
tives of a past generation have dug for him. He is not 
a physiologist nor a philosopher, but a busy, hard- 
working, and perhaps money-making genius. He does 
not discern the wisdom of the advice he has received ; 



94 ALCOHOLIC INEBRIETY. 

or, if he does, he does not see how the wants of his 
family are to be met by any change in his business, 
or his habits, and though the advice is emphatic, it is 
disregarded. 

The result is insanity, in very many instances; but 
when the inebriate and the lunatic are both summoned 
to appear in the presence of the law, to answer, it may 
be, for the very same offence, the verdict in one case is 
likely to be voluntary drunkenness, and additional pun- 
ishment for the offence, and in the other, insanity by 
the "visitation of God," and kindly care in an asylum. 

It is a fact pronounced by the teachings of psychiatry, 
and well known to law and to medicine, that insane 
persons are frequently not only conscious of criminal 
acts, but of the penalties belonging to them, and that so 
far as knowledge may be considered a test of responsi- 
bility, they should not escape the decision or the conse- 
quences of the test. The principle of rewards and 
punishments, is recognized as a governing principle in 
the conduct of lunatic asylums. Patients are removed 
from one ward to another, restrictions are imposed, and 
indulgences granted, as means of discipline. The higher 
motives and faculties are appealed to, the weaker ones 
strengthened, and those which are excessively developed 
or abnormally displayed, restrained. This is a rational 
mode of treatment, which has commended itself to the 
judgment of our wisest alienists, from the days of Pinel 
and Connelly until now. Why not, therefore, deal with 
mental unsoundness outside of asylum walls, in the 
same way? If insanity deprives a person of self- 



INEBEIETY AND INSANITY— HOW BELATED. 95 

consciousness and reduces him to oblivion, and perpetual 
darkness, he is. of course, no longer a responsible being, 
and but one alternative is left to him. If, however, his 
insanity takes the form of an acute and temporary per- 
version of his moral sense, or mental faculties, but does 
not so far invade the sensorium as to deprive him of 
discriminating power, I see no reason w 7 hy he should be 
exempt from a wise administration of penal discipline, 
the same as other violators of law, with perhaps less 
knowledge and discrimination, who, in these days of 
sentimentalism, and pseudo-philanthrophy, are so un- 
fortunate as not to be adjudged insane. The busy mer- 
chant, the over-taxed professional man, the speculator 
in politics, morals or stocks, too often rushes on to a 
painful doom, in the midst of the whirl and pressure, 
heedless of his own conditions and fears, and of the 
counsels of his physician. Regardless of w 7 hat they 
know to be the inevitable issue ^of such a course, such 
persons pursue it, until insanity, inebriety, or some other 
damaging disorder of the nerve centres, overcomes and 
enslaves them. Where knowledge is possessed of the 
existence of any morbid predisposition, and of the 
danger of encouraging its development, its possessor 
fairly earns the reward which he will surely receive, if 
he allows his volition to guide him in the path that 
leads to his own destruction. Who shall measure the 
degree of responsibility, in either case, by any other 
standard than that of knowledge, and the power of 
choice ? 

One impressive fact, in connection with the inter- 



96 ALCOHOLIC INEBRIETY. 

change of insanity and inebriety, should be empha- 
sized in this connection. It is this: that a drunken 
carouse not unfrequently arrests and forestalls an im- 
pending seizure of insanity. For example, take a family 
in which various neuroses are exhibited. There are two 
brothers, who hasten and worry with business cares and 
responsibilities, until they are suddenly aroused to a 
consciousness of danger. Headache, wakefulness, indi- 
gestion, irritability of temper, or some kindred symp- 
toms, are manifested. They seek advice, and a change 
of scene, and rest, are recommended. One of them 
stops, and the other continues, as an apparent necessity, 
to conduct the business. The stopper rests, and may 
naturally drift among idle or luxurious people, and dis- 
cover a susceptibility to the alcoholic poison, which is 
intensified by indulgence, until a profound debauch 
occurs. Recovering from it, he finds that the complete 
arrest and revulsion of all his functions, and faculties, 
occasioned by the profound narcotism (intoxication) has 
temporarily subdued the insane diathesis with which he 
was born, and that he is* enabled to resume his labors 
with courage and assiduity. The other, suffering from 
similar symptoms of mental depression, restlessness, etc., 
struggles on, without rest or change. No impulse to 
drink manifests itself, or, if it does, from motives of 
propriety and conscience, he may be able to subdue it, 
while, from continued pressure and resistance, the hope- 
less victim drifts away into the gloomy domain of men- 
tal alienation. Take the cases of two young lawyers, 
both of whom I knew well. 



INEBRIETY AND INSANITY — HOW RELATED. 97 

No. 201, was brilliant and enthusiastic. His father 
died, a victim of over-work and alcoholic intoxication. 
His mother was fond, indulgent and unwise. As he 
came to his majority, with a moderate competency at 
his command, he chose the life of a debauchee, from a 
mere love for it. A few years, however, satisfied him 
that it was a life of wretchedness, and constantly im- 
pending ruin. In view of this disclosure, which came 
to his own consciousness, in moments of serious reflec- 
tion, he resolved to stop. His will, fortunately, was by 
nature almost resistless, and under its guidance he was 
sometimes enabled to stop for a season. Yet at other 
times the old passion would return, with renewed 
violence, and he found the safer course, was voluntarily 
to place himself under restraint. The resistance he was 
compelled to command, in order to subdue his inward 
passion, together with the humiliation of restraint, though 
self-sought, wore upon his nervous forces, frequently to 
the point of exhaustion. 

In this state of extreme depression of body and 
mind, his intellect seemed to reel upon itself, and he 
became clamorous in his demand for his accustomed 
drink, as a means of temporary relief. A moderate 
quantity of whisky, judiciously administered, with milk, 
would have restored calmness, and promoted rest for 
awhile ; but again and again the demand repeated itself, 
till he resolved, with a clear head and an honest heart, 
to do without it, regardless of consequences. 

On one occasion, however, during his struggles, vio- 
lent symptoms of acute maniacal exhaustion supervened, 



98 ALCOHOLIC IKEBKIETY. 

and so intense was the desire for drink, and so unre- 
mitting his demand, even for a single draught, that it was 
evidently a physical necessity to relieve a state of in- 
tense cerebral exhaustion ; but being refused by his 
keepers, he fell upon his knees, and with imploring gaze, 
trembling from crown to heel, died, in a paroxysm of 
frenzy, his friends piously congratulating themselves 
that he had died sober, with reason dethroned, rather 
than aiford him temporary relief, and give a possible 
chance for recovery, by the indulgence of a single glass. 
The other case is No. 86. A lawyer also, not brilliant, 
like 201, but of average qualities and capacity. He, 
too, was determined to martyrize himself, if need be, in 
the struggle to overcome an inherited tendency. The 
other surrendered his reason, and died in an asylum, 
while No, 86 died at his home, with a mind sunken into 
partial dementia, by the struggle of years to keep and 
remain sober. He had been a deceptive, cunning ine- 
briate, who would do almost anything, theft, lying, 
deceit, to procure liquor, and then drink to the extreme 
of helplessness. Year after year, he continued his pota- 
tions, till his capacity for enjoying them was exhausted ; 
and it became a matter of effort, to take a sufficient 
quantity to realize its accustomed effects. In this stage 
of saturation, when every organ and tissue seemed charged 
with the poison, it was heroic to make an -effort to re- 
deem himself, seeing that his moral forces were kept in 
abeyance, and his apprehension of methods and results 
was in subjection to his sensual impulse; but still the 
struggle was commenced. 



INEBRIETY AND INSANITY-— HOW RELATED. 99 

Under a strong conviction of duty, aided by doting 
parents and an ever watchful sister, he succeeded in 
abandoning his cups, but the cost of the effort was a 
complete depression of vital force, a sudden change of 
morbid propensity, an absolute loss of mental poise, and 
a sober death; the death of dementia. The family 
taint was not distinctly marked in the preceding gene- 
ration, though it was evident, in certain idiosyncrasies 
and oddities, that it must some time declare itself in a 
specific form. In this case, also, an inborn proclivity for 
alcoholics terminated in death from insanity. 

This interchange and transposition of morbid inherit- 
ance, in whatever form it may appear, is a significant 
fact which seems to teach that there is almost as much 
reason to believe that intemperance sometimes prevents 
as it does cause insanity. In each of these cases the 
mind gave way with the withdrawal of alcohol. Had 
its use been continued in graduated and medicinal doses, 
under the direction of a wise physician, the end might 
have been delayed, and death welcomed by an unclouded 
intelligence. 

While engaged in writing this chapter my attention 
is called to a case as follows : A young man in humble 
life, a huckster by occupation, calls upon me with a 
relative, and an officer of the law, for advice. He is the 
son of a father, whose wayward life is notorious, and 
whose abiding place is never settled, whether from men- 
tal unsoundness, moral depravity or a love of vagrancy, 
is not known. The wife maintains the home as best she 
can, and the son, during a period of industry, sobriety, 



100 ALCOHOLIC INEBRIETY. 

and filial duty, contributes his portion towards it. The 
time comes, however, when, from constitutional tendency, 
from excess of worry and of work, or for want of occu- 
pation, he becomes wakeful and restless, with loss of 
appetite. Failing to seek advice at such times, he drifts 
into despondency, and has twice been an inmate of an 
insane asylum. On other occasions, he has escaped the 
sequel of his wakefulness, restlessness and anorexia, 
namely, melancholy, by indulging in drink, and has for 
a time been a great annoyance to his family and friends, 
but with the cessation of his debauch, there has always 
been a return of capacity for work. 

Indeed, the views of professional alienists have under- 
gone considerable change, of late years, on this subject. 
It is found that intemperance is not the all-potent factor 
of insanity that it was supposed to be, many years ago. 
The facts of insanity, like the facts of crime, are 
exhibiting new and important physical causes, for 
numerous departures from typical standards of integrity 
of brain, nerve and blood. Civilization, and the civili- 
zation of the American people especially, is an energetic 
force in the creation of new methods of social life, by the 
effective operation of which, new discoveries are being 
made of profound departures in the functional activities 
of our bodies, from the recognized normal standard. 

This fact is frequently shown in an evident instability 
of the great nerve centres, which have to do with the 
processes of intellection, idealism and nutrition. Such 
disclosures are, of course, making their impression on civil 
law, which is constantly being modified in favor of the 



INEBRIETY AND INSANITY— HOW BELATED. 101 

higher and more intelligent apprehension of hygienic and 
sanitary requirements. Witness sanitary legislation, by 
the creation of Boards of Health, with ample powers to 
do what the best scientific knowledge indicates, in the 
direction of public health. 

Dr. David Hack Tuke, of London, than whom there is 
no higher authority on the subject of insanity, expresses 
himself thus, as to the relation of intemperance to in- 
sanity, and especially as to the alleged increase of 
insanity : " I do not deny that there are instances of 
persons whose mental condition is benefited by the use 
of a diet into which some form of alcohol enters, 
especially the light wines and beer. The misfortune is 
that the very people who are likely to be thus benefited 
are often to be found among those who, from noble 
motives, abstain from wine. Thus it comes to pass 
that the folly and wickedness of intemperance involves 
a double evil. Intemperance not only injures those who 
yield to this vice, but it leads many, by natural reac- 
tion and indignant recoil, arising out of the knowledge of 
such abuse, to deprive themselves of a beverage, or even 
a medicine, which might act in their case beneficially, 
in gently stimulating the functions of the brain, and 
lessening the tendency to nervous irritability and lan- 
guor. Those who suffer from the want of a moderate 
stimulant, and fall into a depression which might have 
been warded off by their use, are, I maintain, the 
victims of intemperance, and their discomfort or actual 
insanity lies at the door of the drunkard."* 

*" Insanity and its Prevention/' by D. H. Tuke, p. 203. 



102 ALCOHOLIC INEBRIETY. 

If this is a fair statement, then it is evident that 
abstinence from alcoholic liquors by' persons whose 
health would be benefited by their moderate use is, or 
at least may be, a factor in the production of insanity, 
and it also confirms the observation I have already 
made, and illustrated by the clinical record of the death 
of the two young lawyers. 

The alleged increase of insanity and inebriety, as well 
as other forms of nerve and brain disorder, together 
with their relation to human conduct and domestic 
happiness, has become a favorite theme for study by 
thousands of intelligent persons, which is a most cheer- 
ing sign of the times. The more thought, and the more 
light, that can be brought to bear on this subject, the 
more good will be accomplished. Science has never, 
until recently, found her true place, especially in the 
realm of psychology. She has quietly, and unobserved, 
been plodding her weary ways in the direction of other 
pursuits, while religionists and philanthropists have, 
seemed to possess the entire field, if not of psychiatry, 
of mental and moral unsoundness, as connected with the 
habit of dram-drinking. But this is not sufficient. 
Scientific thinkers are now bringing together inebriety 
and nerves; insanity and brain; crime and heredity ; law 
and justice; all in their own order and relations to each 
other and to society at large. 

Whatever may be said of popular prejudice and igno- 
rance of the fixed routine of legal proceedings, and of 
the implacable repulsion of popular theology, to advanced 
views and methods, we are nevertheless making progress 



INEBRIETY AND INSANITY HOW RELATED. 103 

in this matter. Society is beginning to recognize the 
causation of certain human conditions, which have 
hitherto been misunderstood, but which are now emerg- 
ing from chaos, and asserting their claim upon public 
attention, and which must lead to reforms in jurispru- 
dence, that shall be consistent with its own highest 
aims. 

In a strict ethical sense, there seems to be no differ- 
ence between what is called voluntary inebriety, and 
what may justly be called voluntary insanity, or 
voluntary gluttony, seeing that excessive drinking, 
excessive working, and excessive eating, all spring from 
allied nerve conditions, and are alike productive of 
diseases. If we look backward and trace the lines of 
their descent, we shall generally find that each has its 
antecedent factor in some ancestral fault. A patient 
presents himself for advice, his constitutional tendencies, 
his family history, and his modes of life being all well 
known to the physician who is to prescribe. The phy- 
sician informs his patient, that he is deliberately violat- 
ing the laws of his being, so that the normal harmonies 
of his functional life are thrown out of gear, and that 
unless new methods are adopted, his latent predisposition 
will develop and assert itself, and that the inevitable 
result will be insanity, or some similar disorder, which 
may disqualify him for social, domestic or business life. 
He thinks, however, that he cannot afford to relax his 
routine of daily service. He cannot abandon long 
established habits of living, and he rushes on, contrary 
to advice, till his family weep over him at last, as a 



104 ALCOHOLIC INEBRIETY. 

lunatic, an inebriate, or it may be, a glutton, dying from 
apoplexy or paralysis. It matters a great deal, however, 
in public estimation, how he dies. It matters much to 
the reputation of the family, whether the ban of intoxi- 
cation is upon him, or whether he leaves this world 
because of violating the laws of his being, in the way of 
overfeeding or mental strain. It is, however, true that 
insanity may be frequently prevented, even more readily 
than inebriety. A person with a direct hereditary taint 
of insanity, may pursue a course of life, under professional 
guidance, which will secure him against a public exhi- 
bition of his infirmity, with more ease than a person 
with an alcoholic diathesis, can be kept from indulgence 
and exposure. In the former, there is no physical 
craving to overcome, no struggle with an internal and 
positive demand, which, strong and imperious in itself, 
is rendered more so by the allurements of social, and the 
attractive displays of public life. All that is required 
in the one case is, in the very onset, to submit to intelli- 
gent guidance as to mental and physical hygiene, so as to 
preserve a normal equipoise. In the other, while it is 
necessary to accomplish the same end by similar methods, 
there is the additional task of keeping in subjection a 
strong physical impulse. 

Hunger and thirst cannot be averted by an act of 
will, even in the most exalted health'of body and mind. 
Working, walking, thinking, and all other acts that are 
muscular or physical, are more under control than strong 
physical cravings. The late distinguished Forbes 
Winslow, of London, in writing of such minds, says : 



INEBRIETY AXD INSANITY — HOW RELATED. 105 

" We read the sad, melancholy and lamentable results 
of either total neglect of all efficient curative treatment, 
at a period when it might have arrested the onward 
advance of the cerebral mischief and retained reason 
upon her seat, or of the use of injudicious and unjusti- 
fiable measures of treatment under mistaken notions of 
the pathology of the disease. * * * Experience 
irresistibly leads to the conclusion that we have often in 
our power the means of curing insanity, even after it 
has been of some years' duration, if we obtain a thorough 
appreciation of the physical and mental aspects of the 
case, and persistently and continually apply remedial 
measures for its removal."* 

There is seemingly too much sentimentalism about 
this dogma of insanity. It is environed in the public 
thought, with a host of sympathies, which, while they 
are alike human and humane, are, nevertheless, hindran- 
ces, often, to a proper recognition of its true nature. In 
many a family, there are those who typify inherited 
tendency, showing itself as neuralgia, hysteria, inebriety 
or insanity, all of which are sometimes seen in a single 
household. Take, however, a larger family, a community, 
a town or village, and the same diversity may be observed 
on a larger scale. They all have their places, and each 
class its proportionate and appropriate place. They are 
all deviations from a normal type of humanity, and all 
represent a common origin ; they come from disordered 
digestion, imperfect nutrition, impure blood, and en- 
feebled nerves. 

* See Lettsomian Lectures, pp. 59, 61. 
8 



106 ALCOHOLIC INEBRIETY. 

We have thus far outlined some of the resemblances 
and some of the differences, which are represented in 
insanity and inebriety, and while the distinctive marks 
may not be equally prominent to the view of all observ- 
ers, a few of them are sufficiently clear to be recognized 
by all. In insanity, the judgment is not to be relied 
on. One can never feel safe in accepting the judgment 
of an insane person, even if the subject judged of, does 
not come within the limits of his hallucinatory sphere. 
Sometimes it is even stupefied — collapsed — abolished. 
The higher intellectual faculties may, however, be so 
slightly disordered, as to render it difficult to determine 
the imperceptible passage from a normal to a diseased 
condition. In either state, there is a sense of insecurity 
and danger. We would not for a moment, set out upon 
a journey in a vehicle with its wheels, or axles, or any 
part of its running-gear visibly out of order. We would 
also feel timid and apprehensive of accident, if we 
knew of any part of the vehicle, even if out of sight, was 
slightly damaged, either by accident or ordinary wear. 

So, if we see in a fellow being, positive evidence of 
brain lesion, we cannot trust ourselves to the guidance 
of his judgment, even in trivial affairs. If, however, 
there are no visible signs of brain disorder, and we 
only know of the pressure of eccentricities and obliquities, 
which are sufficient to entitle their possessor to the 
suspicion of insanity, we are on our guard, apprehensive 
and expectant, to a degree that destroys confidence. 

Again, the persistency of the insane mind in holding 
on to its delusions, is worthy of notice as a characteristic 



INEBRIETY AND INSANITY— HOW RELATED. 107 

sign; persistency in the direction of delusions. It need 
not be always the same delusion, but yet in the same 
course. Delusions in inebriety, are transitory, and soon 
pass away. They are as frequently due to sympathies 
with remote organs, as to any immediate impression 
upon the cerebral substance. 

Just at this point we may pause to recognize the 
difference between mere functional, and organic disturb- 
ances. There is nothing more common than to have 
delirium manifest itself in the career of certain acute 
disorders, as in rheumatism, typhoid and typho-malarial 
fevers, but the delirium in such cases, is symptomatic 
and sympathetic. It does not betray any lesion of the 
brain, or its coverings. It is an expression of transient 
nerve disturbance that may pass away in a few hours, 
unless its invasion is so coaiplete and overpowering as 
to be itself a symptom of death. Delirium tremens is a 
disease that may be so classified, and as this disease is 
not confined to the consumers of alcoholic drinks, it is 
fair to assume that the theory of blood poisoning as the 
cause, does not hold good. It is more rational to 
assume that the toxic force of the drug is expended 
upon the nerve centres, and that the symptoms vary 
accordingly. Delirium in such cases is not insanity, as 
we generally believe and accept the term. 

It has been shown in another chapter, that superin- 
tendents of insane asylums in their organic form, as an 
American Association, have distinctly proclaimed their 
position in this matter. 

Their opinion is decided, that inebriates are not con- 



108 ALCOHOLIC INEBRIETY. 

sidered as insane, or at least not sufficiently so to be 
committed to asylums for the insane, where their presence 
is prejudicial to the latter class, 

This declaration, coming from the source it does, is 
entitled to weight, and will have its influence. 

Assuming it to be true, then, as stated by these expert 
alienists, that the presence of inebriates in asylums and 
hospitals for insane, is offensive and injurious to the 
legitimate occupants of such institutions, it simply nar- 
rows the foothold upon which the inebriate is obliged 
to stand, in making an effort to redeem himself from the 
curse that blots his name, and burdens his nature. 
Already repudiated by society, the church door closed 
against him, business interests kept from his grasp, and 
even the lowest ambitions crushed out of his struggling 
selfhood, with no hand to guide him when at large, and 
no hospital roof to cover him when debauched by excess, 
or raving from thirst madness, his relation to the world 
in which he lives, and to the local community of whicbuhe 
is one of the constituent parts, is certainly phenomenal, 
and demands explanation. Fortunately, there is one 
spot to which he has an inherent claim, and to which 
he may, in the large majority of cases, return, and that 
is, home. Unfortunately, however, his presence at 
home, is often dangerous to the home itself. When he 
goes to it inebriated, he carries with him fear, sorrow, 
shame, and sometimes, worse than all, penury and death. 
When not inebriated, home does not comprehend him, 
nor does it know how to protect him from himself and 
his secret foe, when sober. 



INEBRIETY AND INSANITY— HOW RELATED. 109 

The law is, of necessity, without heart or sympathy. 
It does not know what such qualities are. It would not 
be law, if it possessed them. It is inexorable. It knows 
no higher virtue, than obedience to its own commands. 
Its duty is to protect the injured family, or community, 
by the arrest and the confinement of offenders, but to 
offenders, it grants but little sympathy or moral help. 

Temperance Societies succor drinking men, when 
they are sober, but in the hour of keenest strife with 
self, when the pledge that has been honestly taken, and 
the sense of honor involved in its violation, and every 
manly sentiment and principle, that dwells in human 
nature, all array themselves, as a shield to fortify and 
give conquering strength ; in that moment, such condi- 
tions, and such memories, and such convictions, are as 
available to control a paroxysm of mania, to prevent a 
seizure of hysteria, to antidote a poison of malaria or 
smallpox, as they are of themselves, to subdue the mania 
for thirst in the constitutional inebriate, and hence the 
appliances of the temperance society are unequal to the 
emergency. This is not due to any lack of sincerity, of 
earnestness, or of correctness of principle or plan, on the 
part of temperance workers, but simply to a want of 
compatibility. There is an essential and radical lack of 
adaptability of measures to the evil to be corrected. In 
closing this chapter, it is but just to admit the impossi- 
bility of defining insanity in such a way that there need 
be no doubt or hesitancy in its diagnosis, and equally 
just to claim, that when inebriety declares itself as a dis- 
ease, there is no cause for doubt or hesitancy in pro- 



110 ALCOHOLIC INEBRIETY. 

nouncing it as such, and that in this respect there is a 
clear difference between the two. If, therefore, it is 
impossible, or even extremely difficult, to establish the 
fact of insanity in many cases, it is evident that the 
boundary line between it and a perfectly sane and 
normal and mental state, is beyond the limit of human 
skill or judgment. We cannot, however, go far astray 
in adopting the conclusion, that insanity and inebriety, 
though allied disorders in some of their respective 
features, are nevertheless distinctly different in other 
delineations of their etiology and symptoms. I have 
dwelt upon this topic at this length, on account of the 
practical importance of the subject in its relation to 
jurisprudence, especially, and, indeed, in relation to all 
measures, both private and public, that have to do with 
the prevention or cure of the evil. 

Quotations from different authors, but chiefly from 
the testimony of eminent alienists before the Parliamen- 
tary Commitee of Great Britain, in 1872, in relation to 
the subject of this chapter. 

Dr. J. Critchton Browne, at that time Superintendent 
of the Lunatic Asylum at Wakefield, England, says: — 

" I have come to recognize four forms of mental 
disease, as being specially connected with intemperance. 

" 1. Mania-a-potu, or alcoholic mania, lasting from one 
to two months. A genuine attack of mania, which is 
always characterized by delusions ; it is, as it were, a 
prolongation of delirium tremens, followed by a good 



INEBRIETY AND INSANITY — HOW RELATED. Ill 

deal of depression, and also mental stupidity, indicating 
failure of brain power, subsequent to the excitement. 

"2. The monomania of suspicion, which is a form of 
chronic mental derangement, in which, without excite- 
ment or muscular trembling, we have delusions of 
suspicion. 

" 3. Alcoholic dementia, or chronic alcoholism, charac- 
terized by failure of memory and power of judgment, 
with symptoms of partial paralysis, generally ending in 
death. A very fatal form of brain disease." 

"4. Dipsomania, which consists of an irresistible crav- 
ing, etc." 

" I think that in about one-third of these cases of 
insanity which I found to be due to drunkenness, there 
was a hereditary tendency as a cooperative cause with 
the drunkenness, creating the predisposition. I think 
that the hereditary tendency from drunken parents does 
not always manifest itself in insanity, but frequently in 
idiocy and crime." " Dipsomania is sometimes the 
cause of drinking, and sometimes the product of it." * 
*- . * " The excessive drinking in many cases deter- 
mines the insanity, to which they are at any rate 
predisposed." 

Dr. Arthur Mitchell, Commissioner in Lunacy for 
Scotland, says : — 

" In a fit of ordinary intoxication we have really an 
epitome of an attack of mania, and a man who gets 
repeatedly drunk passes through short attacks of mental 
disease, which may eventually result in permanent 
cerebral disorder." 



112 ALCOHOLIC INEBRIETY. 

" There is niania-a-potu which is not intoxication, 
but is a maniacal excitement which comes on as the 
intoxication passes off." 

" An attack of insanity of that kind may occur in a 
man who was never drunk before, and who was never 
drunk afterward." ***,*« ^j^ man w h f re- 
quently drinks and does not get intoxicated, leads up to 
insanity." 

" The children of habitual drunkards are in a larger 
proportion liable to the ordinary forms of acquired 
insanity, or that insanity which comes on in later life. 
Many habitual drunkards are also strongly predisposed 
to insanity, and what they transmit to their children is 
really that predisposition to insanity which they have 
themselves." 

Dr. John Nugent, Inspector-General of Lunatics for 
Ireland, says: — 

" I knew an instance of a professional man, who at 
one time had been in respectable practice in Ireland ; h§ 
married ; he was unfortunate in his business, and as is 
too frequently the case, took to drink; he had four 
children, and each of the four children was either affected 
with insanity or was malformed ; his wife also took to 
drinking, and she died in a lunatic asylum, and he, it 
w T as said, committed suicide." "I think drinking and 
insanity both act upon each other as cause and effect. 
I think that if there is a predisposition to insanity in an 
individual, indulgence in drink is sure to develop it ; 
and, on the other hand, I think there are persons who 
show their insanity by a disposition to drink." * * * 



INEBRIETY AND INSANITY — HOW RELATED. 113 

" I have in my eye the case of a gentleman of fortune ; 
the father of this gentleman was insane, and he had a 
brother; one of the brothers took to drink, and the 
other became insane without ever indulging at all in 
drink; so that the hereditary disposition showed itself in 
one by actual insanity, and in the other by drinking" 

Dr. Forbes Winslow, London, says: — 

"In the upper classes of society, the insanity which 
can be clearly traced to habits of intemperance, of course, 
is not so great as in the lower stratum of society." * 
* * « There is a morbid craving for stimulants, which 
is clearly traceable to a brain condition; it is a form of 
insanity, although it is not recognized by law." * * * 
" You will never diminish the amount of pauper insanity 
until you deal with the great question of alcohol, and 
by legislation prohibit, as far as you can, its improper 
sale." 

Dr. Robert Boyd, f.r.c.p., London, and University 
of Edinburgh, says : — 

" Of admissions of drunkards to the Infirmary at 
Marylebone, in sixteen there was known to bean heredi- 
tary predisposition to insanity." "Of the sixty-three 
cases examined which died in the Somerset Lunatic 
Asylum, the majority had disease of the brain prior to 
their continuous habits of drink" " I should think in 
the majority of cases, perhaps, the drinking habits 
produce the insanity, but in a great number of cases, 
symptoms of insanity precede the drinking." 



114 ALCOHOLIC INEBRIETY. 

ASYLUMS FOR INSANE AND FOR 
INEBRIATES. 



INSANE ASYLUMS. 

Some years ago I addressed a letter to several of 
the most distinguished physicians in charge of hospitals 
for insane, asking whether, in their judgment, it was 
proper to associate inebriates and insane persons in 
the same building, for treatment. The answers were 
all prompt and decided, in the negative. Inquiry was 
was also made as to the result of their experience in the 
recovery of inebriates who had been placed under the 
discipline of their asylums. The answers were equally 
decided, that the results were altogether unsatisfactory. 
This, I believe, is the universal testimony of all officers 
of insane asylums, as will be presently confirmed by 
resolutions passed at a recent annual meeting of the 
Association of Superintendents of such institutions. 

In confirmation of this testimony of American physi 1 
cians, I offer a few opinions from abroad : — 

" I am more than ever convinced that there should be 
separate arrangements, separate asylums, and separate 
treatments." — Dr. Alexander Peddie, Royal College of 
Physicians, Edinburgh. 

The Association of Dipsomaniacs with the ordinary 
inmates of an asylum operates injuriously in a twofold 
way, both upon the inebriate himself and upon his 
insane fellow inmates." — Dr. Lauder Lindsay, Institu- 
tionfor Insane, Perth, Scotland. 



INSANE ASYLUMS. 115 

" I should object to mixing them. I think it would 
have a deteriorating effect upon those who were not 
insane" — Dr. Thomas Beath Christie, Superintendent of 
Insane Officers and Soldiers of Indian Army, at Ealing. 

The late lamented Dr. Forbes Winslow, so well and 
honorably known the world over, offers his protest 
against the practice of consigning inebriates to insane 
asylums. He says : "I went down to see a nobleman, 
not very long ago, who had been in a state of intoxica- 
tion for four or five weeks ; he had not been sober 
during that time for one day, but I could see nothing in 
his mental or physical condition to justify me in placing 
him in a lunatic asylum. I know numbers of ladies, 
moving in very good society, who are never sober, and 
are often brought home by the police drunk. They are 
wives of men in a very high social position. I have 
been often consulted about these cases ; my hands are 
tied ; I could not legally consign them to the asylum." 
" If we have institutions distinct and apart from 
ordinary lunatic asylums, under a distinct course of 
direction, and perhaps, with a distinct class of inspectors 
and directors, they would, I think, tend very much to 
diminish the amount of drunken insanity." 

Much additional evidence of the same character might 
be given, but I will offer only a few extracts, which are 
from the testimony of the late Dr. Donald Dalyrumple, 
M. P. for Bath, whose efforts gave the first practical 
impulse to British thought in this new departure. He 
reports to the House of Commons Committee, the result 
of his investigations in America on this subject, thus:— 



116 ALCOHOLIC INEBRIETY. 

"I find, moreover, that it is the custom of many 
lunatic asylums to receive inebriate patients ivithout cer- 
tificates, and consequently, illegally, and that a considerable 
revenue is derived from this class of patients, who are 
nearly all of the affluent class." He quotes also from 
the venerable Dr. Stuart, of Baltimore, who says : " In 
the State of Maryland we have the power to retain a 
man non compos mentis from drink, for six months ; but 
it is seldom done, because asylums for the insane are not 
places for drunkards. I am of opinion, that in inebri- 
ate reformatories there will be many a disheartening 
failure, many will rise, and fall again, but if help be 
afforded soon enough and long enough, many an object 
will be able to rise and remain permanently erect/' 

Dr. Dalyrumple further states, "I have made many 
inquiries of persons, other than those connected with 
inebriate institutions (medical, legal, clerical and lay), as 
to the effect produced by them, and received many and 
various opinions, but, on the whole, largely in favor of 
their utility." 

In view of testimony from such distinguished sources, 
it is submitted, that the subject is not without grave 
interest to the common citizen, as well as to every one 
whose profession brings him in contact with either 
insane or inebriate patients. 

The aggregation of numbers of all classes of insane 
persons in one building, in which the immediate charge 
of them must be delegated to ignorant ward-masters, is 
of itself sufficiently at variance with the advanced views 
of modern scientific thought, without increasing the roll 



INSANE ASYLUMS. 117 

of inmates, by including those who are not insane, and 
who are known not to be so, by the officers who receive 
and register them. 

There seems to be a singular propensity on the part 
of some physicians, to magnify the existence of insanity 
by adding the vices and diseases of the same to their 
enumeration. Inebriates are mustered in, to swell the cata- 
logue, while it is no more appropriate to include them in 
the list, than it would be to include merely queer and 
eccentric, or nervous and hysterical people. Numerous 
cases have come within my own knowledge, where 
inebriates, whom nobody would charge with insanity, 
have been committed to insane asylums, and detained in 
them. They appear on the records as insane patients, 
and may be admitted several times the same year, and 
be counted as many times as separate cases. Thus, an 
inebriate may go three or more times in the course of 
his life, to an insane asylum, and appear in the annual 
report as three or more distinct cases of insanity, and by 
such process, the public are led to believe there is a 
large increase in the number of insane. It may some- 
times appear to families and friends, necessary to resort 
to such asylums w T ith sudden cases of acute alcoholism, in 
the absence of any less objectionable place of detention ; 
and there seems to be no good reason why, under such 
circumstances, the cases so entered, should not be tem- 
porarily received as inebriates, if no other temporary 
shelter is within reach, instead of appearing in the pub- 
lished reports as so many insane persons. There are. as 
yet, comparatively few asylums jbr the special care of 



118 ALCOHOLIC INEBRIETY. 

inebriates, and in the wide extent of country that must 
often be traversed to reach them, it is not surprising 
that both private physicians and patients, find it more 
convenient to avail themselves of the nearest lunatic 
asylum • but it cannot be just to the patients, to their 
relations, to $ie law, or to the community, to swell the 
record of insanity, by the indiscriminate addition of the 
inebriate class. Especially is it unjust, in view of the 
fact that the physicians in charge of the insane, almost 
unanimously agree, that inebriates are unsuitable and 
unsatisfactory inmates for their asylums, and that they 
themselves incline to discredit the teaching that alcohol- 
ism is a disease, and hence not a subject for hospital 
treatment at all. 

Dr. Dalyrumple testifies before the British Committee 
that he conversed with two deservedly eminent specialists 
in insanity, whom he met in Philadelphia, on the sub- 
ject of inebriate asylums, and that they threw grave 
doubts upon the permanency and reality of many of the 
so-called cures; and said that " those connected with 
inebriate asylums dealt in general assertions and flourishes 
which diminished greatly, when closely examined/' etc. 

If those gentlemen had made themselves familiar 
with the records of inebriate asylums, they would have 
discovered that a considerable number of the inmates 
had previously been in lunatic asylums under their own 
treatment, and had been discharged. As I write this 
page, I glance at such a record now before me, and 
running over the names of fifty persons admitted, as 
they occur consecutively in the beginning of a single 



INSANE ASYLUMS. 119 

year, twenty of them had formerly been inmates of 
insane asylums, and yet not one of them was found to 
be insane, either by the law or the specialists who 
received and discharged them. 

The record might be pursued further, with an accu- 
mulation of similar evidence. The fact is, that there is 
a class of alcohol patients who are incurable, and who 
go from one institution to another, testing the qualities 
of each, and who take as much pride and pleasure in 
rehearsing their various experiences, as a tourist on his 
return from travel does in narrating the incidents and 
experiences of his journey. Such facts should inspire 
gentlemen who have charge of institutions, with a degree 
of candor, more than was exhibited by those experts in 
insanity to whom Dr. Dalyrumple refers, who became 
the unauthorized and voluntary exponents of the 
character and results of inebriate asylums in America, 
which they probably had never visited, and with which 
certainly they have had no practical experience. Dr. 
Dalyrumple, however, determined to prosecute the in- 
quiries himself, and in doing so, by personal visitation, 
and careful study of the whole subject, he concludes and 
reports, that the managers of inebriate asylums on whose 
soberness and fairness most reliance can be placed, are 
candid enough to admit the defects and abuses to which 
their institutions are necessarily subject, and that not- 
withstanding these, the results are abundantly satisfactory 
and encouraging. 

In dwelling upon this branch of the asylum view 7 , I 
am impelled by a conviction that the people have been 



120 ALCOHOLIC INEBRIETY. 

strangely misled in this matter, and that the reactionary 
impulse, which has now taken definite form, has pro- 
duced an attempt at a change of base among superin- 
tendents of insane asylums, which has found expression 
in the form of resolutions, adopted at their meeting in 
Auburn, in June, 1875, as follows: — • 

" Resolved, That in the opinion of the Association of 
Medical Superintendents of American Institutions for 
the Insane, it is the duty of each of the United States, 
and of each of the Provinces of the Dominion, to estab- 
lish and maintain a State or public institution for the 
custody and treatment of inebriates, on substantially 
the same footing in respect to organization and sup- 
port as that upon which the generality of State and 
Provincial institutions for the insane are organized and 
supported. 

" Resolved, That as, in the opinion of this Association, 
any system of management of institutions for inebriates 
under which the duration of the residence of their 
inmates and the character of the treatment to whiah 
they are subjected is voluntary on their part, must, in 
most cases, prove entirely futile, if not worse than 
useless. There should be in every State and Province 
such positive constitutional provision and statutory enact- 
ments, as will in every case of assumed inebriety, secure a 
careful inquisition into the question of drunkenness and 
fitness for the restraint and treatment of an institution 
for inebriates, and such a manner and length of treat- 
ment as will render total abstinence from alcoholic or 
other hurtful stimulants during; such treatment abso- 



INEBRIATE ASYLUMS. 121 

lutely certain, and present the best prospects of cure or 
reform of which each case is susceptible. 

" Resolved, Further, that the treatment in institu- 
tions for the insane of dipsomaniacs, or persons whose 
only obvious mental disorder is the excessive use of 
alcoholic or other stimulants, and the immediate effect 
of such excess, is exceedingly prejudicial to the welfare 
of those inmates for whose benefit such institutions are 
established and maintained, and should be discontinued 
just as soon as other separate provision can be made for 
the inebriates." 

It will be proper, in view of such statements, to 
consider the subject from the standpoint of 

INEBRIATE ASYLUMS. 

In an official report made by a competent committee, 
to the "American Association for the Cure of Inebriates," 
in October, 1872, it is stated, that up to a year previous 
to the date of the report (that is, October, 1871), there 
were 5959 persons admitted to the several Asylums 
represented in the Association, and that of this number 
5557, or 94 per cent., were voluntary patients. It is 
also stated by competent authority, that at least 33 per 
cent, of this number, have been cured. But the ques- 
tion is often asked as to their permanent cure. The 
answer is, that such a thing as a permanent cure of any 
disease, a permanent reformation from any vice, or a 
permanent conversion from a life of sin, to a religious 
life, cannot be honestly promised beforehand, or an- 
9 



122 ALCOHOLIC INEBRIETY. 

nounced afterward, by any physician with his patients, 
any philanthropist with his vicious wards, or any minis- 
ter with his lost sheep. The word is a misnomer in this 
intended application of it, but it has become the fashion 
among chronic objectors to the asylum treatment of 
drunkards, to use it, and it is repeated here only for the 
purpose of disclosing its absurdity, by presenting it in 
contrast with other diseases and vices, as follows : — 

Of how many cases of insanity, when they leave 
institutions, can it be said their cure is permanent; 
that there is no possibility of a relapse? 

How many criminals who are dismissed from the 
hands of justice, can be said to be reformed beyond the 
possibility of future failure ? 

How many converts to religion, are so permanently 
established that they cannot fall ? 

It is not in the power of man, safely to assert any 
such result of his own finite work. It may be stated, 
however, as a general fact which challenges scrutiny, 
that the cures of intemperance may be as sure and re- 
liable as any other forms of vice or disease that present 
equally acute and complicated symptoms. 

Inebriate asylums have demonstrated a few facts, at 
least, which cannot be gainsayed. Many intemperate 
men, who have entered them voluntarily, and conformed 
to their teachings, have gone forth to the world, stronger 
and better than before, and are still pursuing sober and 
useful lives, in at least the proportion above stated. One 
man out of three has been saved, and this against strong 
adverse circumstances, in most cases. It has been shown, 



INEBRIATE ASYLUMS. 123 

also, that there are not a few cases of incurable alcohol- 
ism, which may remain quietly and soberly within 
institutions, for years together, and thus shield themselves 
from the risk of debauch, and their families from annoy- 
ance and danger. It is also proved, that asylums are a 
constant public rebuke and warning to the people on 
the subject, which has a deterrent influence in favor of 
temperance. 

There are many persons who have been inmates of 
such institutions, who are among our most valuable citi- 
zens, and who, from the very fact of having voluntarily 
made public confession of their infirmity, by seeking 
asylum treatment, and equally public confession of their 
recovery, do not intend to falsify either the fact of sin- 
cerity in making the effort, or of earnestness in pursuing 
their sobriety, by any inconsistency in this regard, if it 
can be avoided. 

There are, on the other hand, many who are profes- 
sional debauchees, whose other vices are covered under 
the more visible fact of drunkenness, and who are more 
suited to corrective institutions, than to insane or inebri- 
ate asylums. Their chief purpose is self indulgence. 
They are constitutionally vicious and sensuous, and 
care but little for anything, that does not pander to the 
gratification of a low nature. 

Such are not inebriates in the sense that is recognized 
by those who have given the most thought to this 
subject; and as elsewhere indicated, this discrimination 
should be recognized and maintained, by all who have to 
do with such persons, either in the departments of 
medicine, jurisprudence or morals. 



124 ALCOHOLIC INEBRIETY. 

In this connection, attention is invited to the following 
extracts from an address of Dr. Willard Parker, of New 
York, before the American Association for the Care of 
Inebriates, in 1870, as showing another good that is 
accomplished by asylums. He says: "We have 
stated that the inebriate asylum is a school in which 
drunkenness is studied and treated. It is now proved 
to be a disease, and curable. We have learned that 
there are different classes of patients, whose condition 
varies, like their family history. There is one class com- 
posed of those who had healthy and temperate parents, 
and who have had the advantages of education. They 
have commenced drinking socially, and have indulged 
more and more frequently, until disease, as manifested 
by the depraved appetite, is established in the system. 
Tnis class incurred guilt, or in other words, sinned, in 
the beginning, by violating the laws of the system, just 
as the over-eater sins against his stomach, and suffers 
from dyspepsia ; or the over- worker sins against his 
brain, and induces insanity or paralysis. A large pro- 
portion of this class can be cured at an asylum, and the 
time required for that cure will depend upon the dura- 
tion of the disease, and the amount of organic lesion 
which exists. 

The second class is made up of those who are de- 
scended from a drinking stock ; they have inherited a 
tendency or predisposition; have less guilt to answer for 
.than the first class; are less curable, or if apparently 
cured, are more in danger of relapse. With this class 
an irresistible craving occurs in paroxysms, and if they 



INEBRIATE ASYLUMS. 125 

can be shielded, for the time, from the means of indul- 
gence, they are safe until the occurrence of another 
paroxysm. 

There are nations or whole communities with whom 
this fearful tendency to drink is an inheritance, as we 
have seen, to the perversion of their whole character. 

The third class is composed mostly of young persons 
who are depraved in all their instincts, and who do not 
desire either reformation or improvement. They are 
not subjects for the ordinary asylums, and in time wise 
legislation will cause provision to be made for them, 
that the community may be protected against their 
irresponsibility and lawlessness." 

Through the agency of inebriate asylums, there has 
not only been a more critical study of inebriety, but a 
more clear and satisfactory distinction in the varieties of 
its forms. The aspects of vice, crime and disease have 
been more closely observed, and more clearly defined, 
and while in their corporate capacity they have kept 
clear of political and ethical discussions of the subject, 
they have done much to clarify the medium of observa- 
tion in these respects for the people at large. More 
valuable additions have been made to the literature of 
the subject during the past few years, than for a genera- 
tion preceding, and it has reached a class of minds that 
has not hitherto been inclined to the ordinary views of 
the subject. 

That inebriate asylums can improve in their methods 
if they would realize their highest ideal, is admitted, 
but it is asserted, without fear of contradiction, that new 



126 ALCOHOLIC INEBRIETY. 

and imperfect as they are said to be, they have accom- 
plished larger and more practical results with this class 
of subjects than any system within the knowledge of 
the age. 

It is well known that there are some drunkards who 
" recover naturally," that is, of their own unaided 
efforts. They " work out their own salvation " in this 
matter, and are among the heroic men of the times. 

It is said that they constitute about three per cent, of 
the inebriate class ; about ten per cent, of reformations 
are claimed by temperance societies, and it seems to 
me that they are entitled to this award, in addition to 
the quiet family work that is being done, under their 
influence, toward prevention. 

These facts, taken together with the fact that inebriate 
asylums, homes and reformatories record at least thirty- 
three per cent, of their cases restored, and that the 
public sentiment is strengthening every day in favor of 
sobriety and virtue, there should be no cause for dis- 
couragement in any quarter, nor for any other rivalry 
between the different methods, than that which is born 
of high purpose, and earnest effort to accomplish the 
most good for the individual, and the general public. 
In the establishment of asylums and homes for inebriates, 
two classes of effort have been recognized, and the prac- 
tical results have satisfied those who have labored 
respectively in each, that great good may be accomplished 
by both. 

The homes or reformatories, rely upon the moral and 
religious means which constitute the elements of all 



INEBRIATE ASYLUMS. 127 

purely Christian work, and place the physically remedial 
measures, in a subordinate relation to the subject. 

The latter are generally located in cities, and do noble 
service in organizing the inmates into clubs and societies, 
the membership in which, is not necessarily lost by 
discharge from the homes. 

It is the privilege of such persons to continue their 
membership, attend the weekly meetings; and aid each 
other in the outside conflicts of life. Many men by 
such a course, recover their manhood and become useful 
citizens, and thus unwittingly, but nevertheless truly 
and forcibly, reprove the notion that legal inquisitions, 
commitments by courts, compulsory restraint and pro- 
tracted confinement, are necessary for a cure in such 
cases. 

Asylums, which recognize more fully the disease 
theory than is done by the homes, and which generally 
receive the more chronic cases and those known as 
dipsomaniacs, study their cases physically as well as 
morally, organize them for the cultivation of the 
aesthetic qualities of their nature, instruct them as to the 
higher duties of life, encourage the largest possibilities 
of their being, nurture their hopes for a better future, 
and without undue and degrading " compulsory confine- 
ment," release many, after different periods of residence, 
who go into the world again and become useful citizens. 

Such, I trust, is a fair representation of the principles 
and outline of plans, adopted by the institutions in the 
United States for the cure of inebriates. Justice may 
not, however, be done to the subject without reference 



128 ALCOHOLIC INEBRIETY. 

to the laws which provide for arrest and commitment. 
It frequently happens that men run recklessly into 
excess, damage their estates, expose their families to the 
risk of want, and are themselves dangerous to be at 
large when intoxicated. The law provides that in such 
cases, arrest may be made of the offending party, on 
complaint of a near relative ; and after a hearing he 
may, at the discretion of the court, be committed to an 
inebriate asylum for a term of months, a year, or even 
longer, his property being placed in charge of a trustee, 
for the benefit of his family. The law thus serves the 
purpose of defending the family from danger, economiz- 
ing expenditure, and allowing the inebriate to come to 
himself, meditate upon his condition, and if possible, 
reach a state of mind in which he may be capable of 
deliberate action, and resolve to avail himself of every 
help to a better course of life. 

So far as he is related to institutions, however, the 
treatment is the same as that of the voluntary patients.* 
No difference in the management marks the relation he 
may hold towards his family, his property or the law, 
unless he himself exposes the facts, or refuses to accept 
the proffered confidence and freedom. Asylums and 
homes for inebriates cannot conform to the legal stand- 
ard, so far as their treatment is concerned, though the 
law may be used to induce inebriates to conform to 
circumstances and conditions, which shall promote their 
own good. The genius of institutions, is to succor and 
restore the diseased and fallen. The genius of the law, 
is to administer justice, and protect the family and 



INEBRIATE ASYLUMS. 129 

society. Institutions stand between the family and the 
drunkard; the law takes care of the one, and institutions 
of the other, the purpose of both being to accomplish 
the same end, though each operates in its own peculiar 
way. 

Institutions need the law as a resource, which may in 
times of emergency aid them in their benevolent deal- 
ings with men in a state of unconsciousness. But the 
spirit of institutions appeals to such persons to rely upon 
other forces, than those which the law apprehends and 
declares, so soon as the intellect, and moral sense, are 
clearly within reach. The law needs special institutions 
for such cases, in order that the ends of justice, and the 
good of all parties may be secured, and thus the inten- 
tion and operation of both, seems to be entirely beneficent. 

The object of this chapter will have been reached, if 
it shall strengthen the sentiment, that institutions for the 
insane are unfit places for inebriates, and that those who 
conduct such establishments have suffered damage to 
themselves, and to the benevolent work in which they 
are engaged, by so long consenting to be custodians of a 
class of persons, who are not believed to be insane ; and 
also if it shall exhibit the true nature, principles and 
results of institutions for inebriates. 



130 ALCOHOLIC INEBRIETY. 

THE INEBRIATES' VIEW. 

We come now to consider a most interesting feature 
of the subject, as presented from the standpoint of 
inebriates themselves; and it is submitted that no class 
of persons are more directly interested in the subject, 
or have a better right to be heard, than they. 

Surely the lessons of suffering, and the experience 
derived from it, are entitled to weight, in a discussion 
which comprehends the victims, who endure the suffer- 
ing, and learn the lessons. 

I have before me a communication which was care- 
fully considered, and unanimously adopted, at a meeting 
of the inmates of an inebriate asylum, and duly for- 
warded to a convention of physicians and friends of 
such institutions, which was held in New York, on the 
29th and 30th of November, 1870, from which the 
following extract is taken, to represent their side of the 
question. 

" Gentlemen: — We are aware that in offering to 
you our views upon the grave subjects whose discussion 
has brought you together, we occupy the position of the 
condemned criminal, who, his case having been adjudi- 
cated, is simply, pro forma, asked what he may have to 
say, ere the already determined sentence be passed : and 
yet we trust, in appealing to you as our advocates, we 
have come to those whose careful examinations, enlarged 
knowledge, and generous motives, have enabled them to 
set aside hasty conclusions, and common prejudices; and 
that through you we may appeal again to the bar of 



THE INEBKIATES' VIEW. 131 

public opinion, with the hope of a kinder hearing, and 
a revised judgment, which may perhaps be productive of 
higher good. 

"In common life, so intimately mingled is the vice 
of intemperance with some of the offences of the pro- 
fessional criminal, that to most persons they are but 
synonyms. The one is but too often added to the crimes 
of the other, and appearing, as they do, thus yoked, in 
our courts and penitentiaries, it is hardly strange that 
even the good and virtuous should esteem them identical. 
It is not necessary that we should deny this with refer- 
ence to ourselves; for neither our friends nor our worst 
enemies will make against us this charge. 

"Doubtless, to ourselves, as well as to others, the 
cause of our condition is a mystery. We have all been 
educated with a deep respect for religious obligations, 
which we still retain, some of us having been church 
members. Some few have been accustomed to the use of 
alcoholic stimulants in our homes, and find ourselves 
victims to their power, while other members of our 
families, brought up under the same influences, have 
escaped unharmed, and are now occupying active posi- 
tions in the busy world, still indulging more or less 
freely, and with apparent impunity, the appetite which 
has been our ruin. 

"Some of us, in our early business life, were taught to 
believe that an open-handed liberality, and the free offer 
of the glass to our customers, was necessary to success. 
Others remember that in the pursuit of our professions, 
in the freedom and irresponsibility of a students' life, we 



132 ALCOHOLIC INEBRIETY. 

were surrounded by those who joined freely in the 
convivialities of the drinking saloon and wine supper; 
and now, as we look around, and ask for our quondam 
companions, we find a few, and they perhaps the most 
brilliant and beloved of our circle, conquered by our 
common foe; but the large majority have thrown off 
the wild habits of those days, and are now settled in 
their various homes, in successful business. 

lt These are simple facts that startle us, as we recur to 
our own unenviable situation, with the question, why? 
Gentlemen, we do not attempt to answer. We ask of 
you, our judges, to reply. 

" Were they upon whom the tower of Siloam fell the 
worst of criminals? 

" It is not our intention here, however, to argue the 
question of criminality. While we confess to our 
full share of human weakness and sin, and acknowledge 
our unfortunate dependence upon society and friends for 
protection and relief, we have, nevertheless, an inalien- 
able conviction of our right to share, in common with 
others, the elevating influences of our Christian civili- 
zation. Has society extended to us this right? In 
order fairly to answer this question, we respectfully 
submit for your consideration the following propositions : 

"1. That a social ostracism is practiced toward us, 
which is not practiced toward other members of families 
or society who have vices and diseases that are equally 
offensive to morals and equally damaging to the com- 
munity. 

" 2. That church ostracism, in many instances, deprives 



THE INEBRIATES' VIEW, 133 

us of the very sympathies and forces that should 
combine for our relief and restoration. 

"3. That we suffer from legal disabilities, by which 
offences committed in a state of unconsciousness, from 
intoxication, are on this account punished with more 
severity; while the same offences committed during the 
unconsciousness resulting from insanity, or other diseases, 
are mitigated or excused, on account of the same. 

" 4. That our sorrows and sins are made texts for 
sermons; our symptoms and misfortunes are caricatured 
by lecturers and performers, and we are exposed alike 
to odium and ridicule, which has a most depressing and 
damaging effect upon our mental and moral nature, and 
directly predisposes to results against which we would 
guard. 

" 5. That we are expected to change or overcome our 
constitutional tendencies, and reform our lives, under a 
degree of pressure from all classes of the community, 
such as is brought to bear upon no other class of individ- 
uals. 

"6. That in view of these facts we need places of 
refuge or asylums, where we may escape the depressing 
influences to which we have referred, and where, for a 
time, freed from the temptations and associations amidst 
which we have been led astray, we may regain that 
moral tone and power of will which can alone fit us for 
the duties and responsibilities of life." 

The fact of " social ostracism " is presented, in view of 
the domestic training of youth, upon some of whom it 



134 ALCOHOLIC INEBRIETY. 

seems to have no deleterious influence so far as drinking 
to excess is concerned, while upon others of the same 
household the calamity of intemperance falls with resist- 
less power. 

Is it any marvel that in families trained under the 
same roof the unfortunate victims of appetite should 
be surprised with their attitude in relation to those who 
have drank at the same table, followed the same parental 
example, and obeyed the same instructions with them- 
selves, and yet who have avoided this form of excess, 
and risen to honorable and prosperous citizenship ? 

It is, indeed, no wonder that they are startled at their 
own " unenviable position," and that they cry out, " The 
cause of our condition is a mystery ; " and that they 
repeat the inquiry, "-Why is it ? " 

This inquiry, too, has peculiar emphasis, in view of 
the fact that others of the family circle " have vices and 
diseases that are equally offensive to morals, if not 
equally damaging to the community," who escape the 
ostracism, which is visited chiefly, if not entirely, upon 
the inebriate. 

Of their " legal disabilities," they have less cause to 
complain. It is t\\Q province of law to dispense even- 
handed justice. It knows no such thing as sympathy. 
It cannot compound with domestic affection, or social 
friendship. It must shield the family and home from 
outrage, as well as the inebriate from needless exposure 
and danger. It is inexorable, and it may sometimes be 
unwise. 

There are no class of persons who are more self 



THE INEBRIATES' VIEW. 135 

deceived than the intemperate. Suspicious, capricious 
and apprehensive, it is natural that they should have 
distorted views of their surroundings and of the influ- 
ences which they have to oppose, and yet the following 
language of the address just quoted may be accepted as 
true : — 

a We are expected to change or overcome our consti- 
tutional tendencies and reform our lives, under a degree 
of pressure from all classes of community, such as is 
brought to bear upon no other class of individuals." 

The truth is, society has not until recently begun to 
recognize the fact of " constitutional tendency," but has 
attributed the state of drunkenness to the heedlessness, 
if not to the willfulness of its victims. 

The inherited tendency to insanity has been appre- 
ciated, and large appropriations of public money and 
munificent bequests of private wealth have been freely 
bestowed for the care and protection of the incurable of 
this class, and for the recovery of those who are supposed 
to be curable. 

Indeed, public sentiment has become so softened by 
the presence of insanity, that a protest has been made 
against the confinement of the dangerous or homicidal 
insane, either in the same building with the more 
harmless, or yet in the penitentiary with sane convicts. 
So urgent has been the sentiment of philanthropy on 
this subject, that the blunder has been committed of 
adopting the misnomer of " criminal insane," as applied 
to such, and of proposing to erect separate institutions 
for their detention and confinement. 



136 ALCOHOLIC INEBRIETY. 

No enlightened person questions now the constitu- 
tional tendency to insanity, to deaf muteness, to blind- 
ness, to idiocy, to pulmonary consumption, to gout, to 
rheumatism, and many other forms of disease ; and all 
admit that with proper hygienic regulations they may 
each be considerably modified, if not prevented. It is 
even now asserted by many wise jurists, that the ten- 
dency to crime is an inheritance, and numerous proofs 
of this fact are coming to light. 

Inebriates, however, in the popular estimation, have 
been excluded from such considerations, and no allow- 
ance has been made for them on the ground of trans- 
mitted infirmity. It must be that they feel the abrasion 
which follows this cold and unsatisfying response to 
their weary, oppressed and appealing natures. Think 
of the secret struggles that have no recognition, the 
infirmities that have no strengthener, the bruises that 
have no healer, the palsied hopes that have no faith left to 
build upon, the losses of property; home and love, with, 
no one to recompense, and the deep and biting remorse 
that reproaches and poisons the inmost soul with the 
reminiscences, first of weakness, then of sin, then of 
sorrow, shame and penury to self and family, and finally 
of despair ! 

"The drunkard endures more painful conflict to over- 
come his passion, in a single day, than many a passion- 
less passive, soul, who knows nothing of such an appe- 
tite, suffers in all his life," has been said by some one. 
There can be no doubt that there is some truth in the 
declaration; and while I would not excuse the drunkard 



THE INEBRIATES' VIEW. 137 

for willing and known violation of the laws of his being, 
I would invoke for him the same consideration on the 
part of society, that is so generously expended towards 
others, whose sins may not be so public as his, but who 
are as certainly living in violation of both natural and 
revealed law. 

No men have keener susceptibilities than those who 
are conscious that they have fallen. 

None are more anxious to rise, and yet their very 
acuteness to wounds, prevents their rising. 

I have known some to be indifferent to religious 
appeals, and to avoid the means of religious instruction, 
who have been restored to sobriety under the overpower- 
ing motive and influence of business interest, and from 
a decided and obstinate purpose to be independent of any 
purely moral influence; while those of deep sensibilities, 
who have been cultured in religious thought, and 
trained in religious life, from the very fact of the wound 
to their higher nature, and of the reproach they have 
brought upon their professions, and their former lives, 
sink into despondency, and, like lonely captives, give 
themselves up to perish of thirst, amid the wilds of 
desertion and penury. 

There is a profound interest in this fact of the secret 
selfhood of the inebriate. It amounts to an exaggerated 
self-consciousness, which renders him the most difficult of 
all men to deal with, in matters which most concern 
him. At a certain stage of his disorder, he becomes an 
egoist of the most positive type. The very conduct of 
sober society towards him, drives him to himself, and 
10 



138 ALCOHOLIC IXEBBIETY. 

intensifies the consciousness of his personality. The 
more he feels himself drifting away from the domestic 
and civil amenities of life, by his indulgences, the more 
he welcomes the allurements of his own passion, becomes 
the keeper of his own thoughts, and the contriver of his 
own methods. These are symptoms of his dipsomaniac 
tendency. When numbers of such men meet in society, 
and form fellowships, the one thought possesses them. It 
is a secret laid away in the heart of each. 

The inward conflict is between the impulse to satisfy 
the propensity of their nature, and the ever haunting 
visions of home and duty, that follow them, and of 
tongues that whisper, while conscience is full-voiced with 
warning. Still the conquering impulse drives, the will 
lies prostrate, and the debauch is accomplished. 

When it is over, the horrors come ; the terrible strife 
between the inner and the outer man. 

The moral, for the time may get the mastery, and 
solemn resolves be made, resolves that are too hastily* 
made, because the will and the purpose, which are 
largely dependent upon physical conditions and forces, 
are defective, and insufficient for the crisis. 

These sketches of the a inebriates' view" are believed 
to be real, and it is an important question how far 
society has adapted its appliances to their condition. 

I am aware that there is a reverse side to the picture. 
Society itself has its rights, and it must protect itself. 
The family has its rights, and they must be secured ; but 
the question is, whether society and the family cannot be 
better served, by looking at and dealing with the 



HOW TO DEAL WITH INEBRIATES. 139 

inebriate as he is, and not as a false sentiment conceives 
him to be. 

In the following chapter this question will be consid- 
ered. 

HOW TO DEAL WITH INEBRIATES. 

As within the whole range of pathology, there is no 
more intricate inquiry than into the actual signs of the 
alcoholic diathesis, so there is nothing in the domain of 
the materia medica, more difficult to find than a remedy 
or remedies for it. Therapeutics also, the science of 
preparing and applying remedies to diseases, stands in 
the presence of inebriety, listless and strengthless, unless 
we recognize in its scope, the entire range of hygiene and 
dietetics, granting at the same time, a share of influence 
to measures that are effectual in awakening the moral 
and emotional nature, and relying upon its agency in 
arousing antagonisms to the disorder, by its reflex influ- 
ence upon those nerve centres that are the most directly 
concerned in the development of primary symptoms. 
In this connection, also, a large place should be awarded 
to prophylactic methods, which, while they may not 
directly affect the present, must have an important bear- 
ing on the future of any given case, or its offspring. 

We shall, therefore, commence the discussion of this 
topic with the assumption, in the very onset, that no 
single specific remedy for inebriety, has as yet been 
discovered, either in the realm of physical or mental 
forces. 



140 ALCOHOLIC INEBRIETY. 

As is the case with a great variety of neurotic disor- 
ders, the co-operation of the patient is essential to the 
remotest degree, to a proper management of the case. 
On his part, and on the part of his family, it is requisite 
that there should be an intelligent apprehension of the 
conditions to be overcome, and a confident reliance upon 
methods to be employed. 

The first thing to do, is to change the standpoint of 
observation j to get on a common ground and occupy it. 
Study the subject from a new outlook, recognizing the 
dogma of disease, as the basis -of all effort toward 
prevention or cure. 

Notwithstanding all that has been said and written to 
the contrary, facts demonstrate that inebriate asylums 
and reformatories, as they are severally called, have 
done more, in proportion to the number of inebriates 
who have been under their care, to restore and establish 
them in their normal relations to the family and to 
society, than any other instrumentality. ♦ 

This has been accomplished, not by specific medica- 
tion, nor yet by appeals to the moral sense. It has been 
done, not by pledges, nor yet by the enforcement of 
disciplinary regulations. It has been done at great odds, 
by the recognition, first, of a diseased body, and its 
dependence upon extrinsic agencies to fortify it against 
the morbific forces which have disturbed its normal 
equipoise. It has been done, secondly, by the creation 
of a model family bond, which recognizes mutuality 
of interest, and an obligation to maintain it, by the 
exercise of mutual confidence and trust. To build up 



HOW TO DEAL WITH INEBBIATES. 141 

the. waste places that have been desolated by the existing 
morbid elements, which has rendered the case suscept- 
ible to the toxic touch of alcohol, has been the chief 
purpose of all interested parties. It has been done, 
thirdly, by the faithful observance of hygienic laws, and 
the avoidance, so far as possible, of exciting causes. 
There is no mystery, nor has there ever been, about 
institutions for the cure of inebriates, and so soon as any 
household in which this disease of inebriety becomes 
apparent, shall be equipped with the simple appliances 
and methods, that have been found to be essential to such 
asylums, and the genius that has inspired and controlled 
them, shall become the prevailing inspiration of the 
family, there shall have been inaugurated a revolution 
in the life of that domestic circle, that shall make itself 
felt as a power in the social life of a community. 

The first thing to do, then, is to place inebriety along 
side of its kindred disorders, by removing it primarily 
from the domain of morals, and dealing with it, as 
allied conditions under other names are dealt with. 
Everybody knows that there are diseases that are a source 
of constant trial and disappointment, both to families in 
which they are found, and to physicians who are called 
to treat them. Unclassified, and even unwritten dis- 
orders, nameless and mysterious, which are the out- 
come of our intense American life, for which little can 
be done, without time, patience, and earnest research into 
the laws of our being, and the multiplied forces about 
us, which tend to disturb them. From their very com- 
plexity, not always preventing the patient from attending 



142 ALCOHOLIC INEBRIETY. 

to business, and yet creating distress and disorder, 
wakefulness at night, and irritability and restlessness 
during the day, they cause, not only discontent and un- 
happiness on the part of the invalid himself, but distrust 
and suspicion on the part of associates and friends. 

While I write this paragraph, a lady calls for advice, 
with the following story : Aged 35 ; frequent and 
unaccountable palpitation of the heart ; obstinate consti- 
pation, requiring frequent medication ; gloominess, dis- 
trust and suspicion of others, making herself and her 
family unhappy. Among her peculiar and specific 
symptoms, are the following : Odors of flowers bring 
on paroxysms of short and difficult breathing (halluci- 
nation of the sense of smell) ; the act of deglutition is 
often accompanied by severe pain in the breast, and 
spasms of the larynx, so that she is obliged to leave the 
table ; with it all, she is apparently in good health ; sleeps 
and eats well, but is oppressed and moody, because she 
is not understood. Having but little sympathy from * 
others, she has become self-conscious to a marked degree. 
Her friends tell her that her sufferings are imaginary, 
and that all that is necessary for her to do, is to exercise 
her will, and subdue her morbid imagination. Hence 
her suspicions. She sometimes, in her forced confidence 
in others, mistrusts herself, and begins to doubt her own 
sincerity, until an actual pain shoots through her frame, 
or some part of it, and her heart repeats its throbbing 
with undue violence, and she is re-convinced that her 
sufferings are actual, and entirely beyond the control of 
her will. 



HOW TO DEAL WITH INEBRIATES. 143 

At times, she has temporary local paralysis, now in 
one limb, and again, in another, and yet, in the intervals, 
walking and working with the alacrity of health. She 
is a mystery to herself, and feels that she is the cause of 
extra care, and a grievance at home, and then she desires 
to escape from it. There is no place so uncongenial as 
home. It is the scene of her conflicts and sufferings, of 
her suspicions and fears. The faces that she sees about 
her, are sometimes expressive of sympathy, but oftener of 
doubt and suspicion. The ministries that come to her 
during her hours of pain and struggle, she feels to be 
the ministries of necessity, rather than of cheerful love. 
Unhappiness is her allotment, and the tendency of her 
bruised and neglected (?) nature, is to employ narcotics 
that she may find relief, and yet, realizing the danger of 
such use, seeks counsel that she may escape the debauchery 
of drugs. 

Such cases are of frequent occurrence. Their name 
is legion, for they are many. Among them inebriety 
has a conspicuous place, and it cannot be separated from 
others of its class, without doing violence to facts, and 
a grave injustice to the victims of such neurotic condi- 
tions. 

Indeed, the case of the female just narrated, is similar 
in many respects to that of inebriates. She was on the 
way to intoxication. She stood on the brink of the 
precipice. She felt that she would be benefited by a 
narcotic. She desired to forget her distresses and herself. 
She sought not only solitude, but oblivion. Before 
taking the leap, however, she determined to make one 



144 ALCOHOLIC INEBRIETY. 

more effort, and find, if possible, the cause. It required 
no unusual discrimination to discover, and locate it. 
It was of pelvic origin, and readily relieved. With 
local relief, came general comfort and domestic happi- 
ness. It would be as sensible and logical to ask such 
an one to sign a pledge, that she w T ould never again 
display her suspicions and fears, as it would be to ask 
an inebriate who was subject to the same annoying 
suspicions, and who suffered similar pains, frequently 
induced by local causes, never again to be disconsolate, 
moody, restless, suspicious, which are symptoms of his 
inebriety, and but for which he would not seek relief 
in the intoxicating bowl. 

It is said that the propensity to drink is not 
induced by physical causes. Read, not only elsewhere 
in these pages for the most authoritative testimony to 
demonstrate the contrary fact, but the following, from 
my friend, Dr. Crothers. (See Medical Record, Nov. 
4th, 1882.) 

" A strong, vigorous merchant, with no heredity, and 
temperate, suffered from a partial sunstroke. He 
remained, greatly debilitated, for two months, in bed, 
and then began to use spirits to excess, and was a con- 
tinuous inebriate up to death, four years later. He 
made great exertions to recover, by the pledge and 
prayer, but failed, and died of dementia. The drink 
craving was clearly traced to the brain injury from 
sunstroke." 

Another :— 

" B., a vigorous man, temperate and correct in all 



HOW TO DEAL WITH INEBRIATES. 145 

his habits. At 31 years of age he married, and his 
wife was killed on the wedding tour, in an accident." 
Profound grief followed, with inability to attend prop- 
erly to business. He became sleepless, with loss of 
appetite, which resulted in drunkenness and death. 
The sudden shock, technically a " psychical traumatism," 
was followed by a change in the normal functions of the 
nerve centres, which was the starting point of a general 
moral and physical degeneration. "He talked and 
reasoned clearly, and made efforts to recover, signed the 
pledge, asked the prayers of the church," etc., but the 
change of brain and nerve integrity was the beginning 
of a general disorganization, and things went on from 
bad to worse, in spite of all effort by himself and 
friends. 

" Financial disaster came upon another, a wealthy 
merchant of much character, exemplary and honorable, 
with an inherent dislike for the taste and smell of 
spirits, which were never allowed in his family. Sudden 
poverty, the loss of a wife, and a scattered family, all 
within a few short months, turned his hair gray and 
left other marks of physical change. Suffering told 
upon him, and the changes that were wrought in his 
constitution, were in the direction of dishonesty, untruth- 
fulness and intoxication. Great efforts were made to 
save him, which he appreciated and tried to assist, but 
in vain." 

The same thing we see as the result of acute disease or 
accident; — change of character, perverted tastes, leading 
to vice and immorality. We need but walk the wards 



146 ALCOHOLIC INEBRIETY. 

of a lunatic asylum, to hear the most obscene utterances 
from the lips of virtuous and refined women, the most 
profane and boisterous language, from men who, when 
sane, were renowned for their purity of life, and honorable 
intercourse with their fellows. 

Insanity and inebriety come from the same stock, 
though varying somewhat in feature and career; and 
similar injuries to nerve structure, or function, will be 
developed alike, both in the insane and intoxicated. 

This rather lengthy divergence from the line of 
thought that was being pursued, seems allowable for the 
purpose of emphasizing the fact, that inebriety may be 
classified with other neuroses, and should be so consid- 
ered, in order to enter upon a proper course of treatment. 

The new departure for patient, family and physician, 
involves the acceptance of the doctrine of disease, as it 
has been disclosed in these chapters. If disease, there 
need be no shame, or self reproach, attached to the fact 
of its existence, unless, indeed, it has been developed by 
a reckless and wanton life. Neither should there be* 
reproach or rebukes on the part of others. The gulf 
between sober and intemperate people, need not be the 
dark and dismal chasm it now is. It may be bridged 
over by a strong and steady span, that will allow both to 
meet, and occupy a common ground. There need be no 
concealment of symptoms which preface a debauch, nor 
of avoiding the issue that is sure to come, if premoni- 
tions are disregarded. I have so frequently seen cases 
in which an approaching debauch has been prevented, 
that I dare speak with assurance upon the subject. At 



HOW TO DEAL WITH INEBRIATES. 147 

this moment I have a vivid recollection of an intelligent 
physician, who at times was subject to attacks of mental 
depression, which were invariably followed by a drunken 
carouse. He came home one evening in great haste, 
showing unusual evidences of excitement and apprehen- 
sion, feeling, as he did, that he was drifting into drunk- 
enness, and urgently pleading with me to save him from 
such a calamity. A brief examination revealed a single 
fact, upon which the whole case turned. He was con- 
stipated, and an active cathartic cut short the paroxysm, 
though he requested to be guarded or restrained till the 
medicine should take effect. Had he concealed this 
fact, or not been made aware of its reflex influence upon 
his nervous system, he certainly would have fallen into 
the condition he was .anxious to avoid. Finding relief, 
and learning from this single experience, how easily he 
could be thrown from his balance, he was always after- 
ward on the alert, and able to discern the premonition, 
in time to prevent an attack. 

The premonition in his case, was not always the same. 
Constipation it might be again, or headache, or indiges- 
tion, or neuralgia, but whatever it might be, he had 
learned to look upon it as an exciting cause, or at least 
as a friendly premonition, and in using suitable remedies 
for the relief of his symptoms, his balance was main- 
tained, and a sober life was afterwards the result. 

Inebriates, however, are not, as a rule, persons who 
begin a career of intemperance by looking out for pre- 
monitory symptoms, or who try to learn the grave lessons 
which they teach, with such accuracy and emphasis. 



148 ALCOHOLIC INEBRIETY. 

They are, however, persons who, once aroused to the 
fact that their inebriety is due to physical causes, which 
it is often in their power to discover, and sometimes to 
prevent, may be strengthened by such knowledge, 
and so far fortified with the means of self help. Their 
most intimate kindred and friends should likewise be 
informed, that though the objects of their concern may 
sometimes be overpowered by such symptoms, and fall 
into degrading excess, all their inner moral life should 
not therefore be assailed, as debased and ruined, but 
that they should stand in the presence of home and 
of society, as conquered victims of a physical disorder, 
for which aid should be sought, as in other bodily ail- 
ments or infirmities. Could society bring itself to such 
a standpoint, or could the inebriate himself, feel that 
his own consciousness of physical defect or injury, was 
sustained by the intelligent sentiment of the society in 
which he moves, he would naturally and promptly seek 
counsel and relief, without the sense of shame and dis- 
honor, which is now the millstone about his neck, that 3 
sinks and drowns him and his comrades, in hopelessness 
and death. In this connection, it should be stated that 
these prodromic symptoms are more apparent, and more 
accessible, in that class of inebriates who are known 
as periodical, or more properly, paroxysmal drinkers; 
who are sober weeks or months, without any inclination 
to indulgence in the interval. The case of the neurotic 
female, just narrated, represents a class of symptoms that 
should be looked for in such cases. 

Common expressions among such persons, are, " I had 



HOW TO DEAL WITH INEBRIATES. 149 

the blues/' "I was down in the mouth." "I was 
cross and ugly at home, and suspicious." " My appetite 
failed me." " I was restless, sleepless, had night sweats, 
and was generally out of sorts." These are common 
modes of expression, but they are definite and descrip- 
tive, and important also. It remains for the adviser, 
medical or family, to ascertain the cause of this condi- 
tion, in its several phases, and then to remove or modify 
it if possible. If this can be done, the debauch is pre- 
vented, or even arrested after it has commenced. This 
has not unfrequently happened in my own experience. 
The habitual drunkard belongs to another class. He 
has no protracted intervals of sobriety. He frequents 
the saloons before breakfast, perhaps, and keeps up his 
potations till midnight. He does not go off on " sprees," 
as the term goes. He is not free from the alcoholic 
impression at any time. He is more or less alcoholized 
continually. Can the habit be broken ? The moral 
sense of such persons is frequently blunted, it is true, 
and yet there is no occasion for despair. The will power 
is enfeebled, it is true, and yet if the will of another is 
permitted, for the time being, to assume control, there is 
hope. How feeble the will is, how powerless some- 
times, is witnessed in the frequent violation of pledges 
and vows. It is said by some, that the will is always 
supreme, and that it is always at command, and only 
requires to be exercised in the right direction, to secure 
desired results. Facts do not sustain this view. The 
poison of typhoid fever prostrates a strong man, and he 
becomes as a child. Why not the poison of Alcohol ? 



150 ALCOHOLIC INEBRIETY. 

The wear and tear of life exhausts nervous energy, 
prostrates vigorous manhood, and subjugates the will. 
The unnatural friction of a dissipated life, with all the 
depleting forces of excess and debauchery, will do the 
same. The will-power of an alcoholized person becomes 
a toy in the grasp of an overpowering passion, that is 
for a time invincible, and is only subdued by the expendi- 
ture of its own violence. 

To place the constant drinker in circumstances that 
are favorable to his recovery, he should be under the 
control of a ruling mind, and give his 'consent to such 
an arrangement. He naturally dreads the immediate 
withdrawal of his accustomed stimulants, and the sense 
of fear of the consequences of such withdrawal, is at once 
an obstacle, and a hindrance. My practice has been, in 
treating hundreds of such men, to assure the timid, 
trembling, fearful cases, that they shall not be allowed 
to suffer, or subjected to any risk, by a too sudden 
deprivation of all stimuli. They shall still be allowed, 
if necessary to sustain them, a certain quantity, medici-* 
nally, the difference being, that instead of taking it at 
their pleasure, for the purpose of exhilarating them, 
I shall administer it according to my judgment, to 
prevent their sinking, or falling to a dangerous level. 

This is a change of base at once. It is reasonable and 
consonant with sound practice in other maladies, and 
without a cell and a key, some such argument is espe- 
cially wise. It often assures confidence. To avoid shock 
in such cases, is as important as it is in surgical prac- 
tice. Habitual inebriates are not usually men with 



HOW TO DEAL WITH IXEBEIATES. 151 

a strong inherited diathesis, similar to that of the parox- 
ysmal drunkard. They have possibly developed the 
disease by the inordinate use of alcoholics, and in so 
doing, have set up a series of morbid changes, which are 
symptomatized by a variety of functional disturbances, 
that require close watching and careful management. 
Some form of liver or kidney disease is almost sure to 
attach to the history of such cases, or a complication of 
some kind, is frequently noticed, as having existed prior to 
the adoption of the habit. In view of the general dis- 
turbance of function, and of possible structural change, 
it is safer to proceed cautiously and work patiently. 

Nothing can be more unphilosophical or unreasonable 
than to expect such a person, by a mere act of will, or 
by subscribing to a pledge, to abandon at once the habit 
of years. There are disordered functions to be corrected. 
They may be cardiac, gastric, renal or hepatic, or any 
combination of these, and the natural order of things 
will not be restored by any mere act of the judgment or 
will, nor yet by the punitive behests of law. 

First interrupt the habit, cut off the allowance at once, if 
it can be done without risk, substitute such remedies as 
the symptoms may indicate, and the improved capacity of 
the system will allow. The reason why so many fail to 
keep the pledge, is found in the fact that they take it 
when, in the very nature of things, it is impossible for 
them to live by it. During the existence of these func- 
tional disturbances, which are continually aborting every 
effort of the mind to control itself, it is folly to attempt 
the assertion of a normal self. Much more is it absurd 



152 ALCOHOLIC INEBRIETY. 

to rely upon any such proceeding, to arrest or control 
organic deterioration; and the use or disuse of drugs, 
whether alcoholic or not, depends largely upon the 
indications presented by t;he organic lesion whatever it 
may be. By pursuing such a course, many persons who 
have been addicted to alcoholic use in excess for many 
years, have been restored to a state of sobriety, though 
they are frequently, perhaps generally, left with an 
entail of chronic disease, which finally carries them off. 
They die from chronic alcoholism after years of total 
abstinence. They may appear on the mortuary list as 
having died from paralysis, brain or liver softening, or 
other form of vital impairment, but the true patho- 
logical description of cause, would be alcoholism. There 
are, doubtless, living to-day, many men who were once 
intemperate, and who will never again use alcoholic 
beverages, who will die of alcoholism. The tissues 
have been poisoned, and so continue through years of 
sober living, in which they are said to have reformed. 
They have abandoned the habit of drinking, and thus* 
given nature and remedies a chance to do their part 
toward reinstating the patient in a normal relation to 
society and to the world. The machinery, however, is 
impaired beyond renovation, and it only works with 
the semblance of normality, by the strictest watchfulness 
and care. 

An excellent gentleman once called on me in behalf 
of a ward, for whose welfare he was deeply concerned. 
The young man w r as an habitual drunkard, though the 
proprietor of a temperance restaurant, in which employ- 



HOW TO DEAL WITH INEBRIATES. 153 

merit he engaged as a means of keeping him in the path 
of sobriety. After describing the case and expressing a 
strong desire that I should visit his ward, he made this 
remark : " I do not expect you to cure him, Doctor, for 
he is always under the influence of liquor, and yet able 
to attend to his business, but is restless, excitable, busy, 
and all the time on the go. He does not stop long 
enough to think, and I have lost hope of any human 
agency being of use to him. The most that I can 
expect you to do for him, is to get him sober, and keep 
him sober, and quiet long enough to give God a chance 
at him. That is all." This proved to be an interesting 
case. He was sobered, became quiet and thoughtful, 
and doubtless the coveted " chance " was secured. He was 
a youth of abundant resources, fond of history, a poet, and 
of considerable literary culture. With such resources 
within himself, and by the use of suitable remedies to 
meet the unusual conditions of his body, his course of 
life was changed for a time, so that he was really called 
a sober man ; but disease had fastened upon him, and he 
could not for any considerable length of time endure the 
struggle it cost him to keep sober, and finally, as I 
believed, died from alcoholism, though the record of the 
Health Officer after his name was, "Died from Paresis." 
Such is the history of many an habitual inebriate. 
They struggle with themselves, by themselves, and 
against themselves, and succeed in walking soberly for a 
time ; but the poison has written its own name on their 
vitals, and whatever the death certificate may record, 
the fact of pathology is, "Alcoholism," 
11 



154 ALCOHOLIC INEBRIETY. 

Thus far we have been considering symptoms, most of 
which were preceded by prodromic signs, that announce 
their approach so regularly, that they are finally recog- 
nized as belonging to the condition which it is our object 
to .overcome; but the truth is that this is not always 
the case. 

It happens in the experience of most families who are 
visited by this calamity, that drunkenness forces itself 
upon them, without being heralded beforehand, by any 
observed admonitory symptoms. It is only by experience 
and repeated ^observation, that they are understood, and 
their approach looked for. It is after repeated surprises, 
that the intelligence is thoroughly aroused to anticipate 
them, but that they usually exist is true. They may be 
overlooked bythe patient himself, or if he is warned by 
them, he fails to recognize their correlative relation. 
Such may be called cases of acute intoxication, and 
how to meet them is a difficult problem. A few 
suggestions, however, may be appropriate. Some ine- 
briates are boisterous and threatening; they come to 
their homes infuriated by the recollection of some pre- 
vious, and perhaps long-buried family discontent, in 
which they invariably esteem themselves to be the 
aggrieved party, and pour forth their anger and abuse 
toward those whom they should protect. In such a 
state of things, opposition, reproof, excitement of man- 
ner or utterance, or the exhibition of timidity, increases 
the difficulty and risk. On the other hand, too much 
kindness or strained attention, with a view of overcom- 
ing his rage by kindness, he intuitively regards as 



HOW TO DEAL WITH INEBRIATES. 155 

unnecessary and undeserved, and it thus is frequently 
the occasion of increased excitement. It is better to be 
quiet and not retaliative ; indifferent, rather than too 
regardful of his demands or threats ; and when address- 
ing him at all, to do so with a calm, deliberate, self- 
contained manner; and generally in a low tone of voice, 
in which, however, there should be the evidence of firm- 
ness and truth. I have frequently quieted the most excited 
and boisterous, by a calm semi-whisper, communicated in 
a confidential style, that almost invariably commands 
attention and respect. Even in delirium tremens, or in 
that prodromic wavering of intelligence and paroxysmal 
shuddering, which are its precursors, a soft answer, in a 
measured whisper, in a close, confidential manner, will 
often soothe the patient, and render him amenable to 
treatment that would otherwise be resisted. Especially 
if the key-note is struck of some favorite theme, on 
which his mind is known often to linger, it is surprising 
to witness, how prompt is the transition to a state of 
comparative composure. 

On the other hand, there are cases that can be most 
effectually controlled by firmness, and a quick decisive 
manner. I have known some men, intellectual inferiors 
to their wives, stagger to their homes, with scarcely 
a consciousness of their going, blunder across the thresh- 
hold, and come suddenly in the presence of their wives, 
who would scarcely stop from their occupations longer 
than to order them immediately to their rooms and their 
beds. And no sooner w T ould the order be given, than it 
would be obeyed, with all the submission of a truant 
child returning with penitent steps to his home. 



156 ALCOHOLIC INEBRIETY. 

The physical treatment in such cases is simple. 
Nourishment, in a concentrated form, is indispensable, 
and nothing is better, or more likely to agree with the 
stomach, than milk, or well-seasoned beef tea. Sleep 
must be induced, and if the stomach is able to retain 
the nourishment, sleep will generally follow.* If, how- 
ever, there is continued insomnia and a probability of 
a return of excitement, as there will be in such circum- 
stances, Hydrate of Chloral is the most decided and 
effective medicine to be used. Though I have frequently 
found that a -moderate inhalation of washed sulphuric 
ether, will produce a temporary calm, which, if 
frequently repeated, with the return of a tendency to 
wakefulness, will eventually calm the nervous irregu- 
larity, and allow good, wholesome, refreshing sleep to 
come. The question here arises, is alcohol in any form, 
admissible in the treatment of these acute cases. I am 
aware that in some circles it is not orthodox to admit 
the possibility of alcohol being serviceable in any 
quantity, to any individual, in any condition of body or 
mind. To this statement I cannot assent. It is per- 
nicious in itself, and doubly so in practice. Alcohol is 
a cardiac stimulant, of great value, and in cases of fail- 
ing force, of heart debility, of sinking or of syncope, 
it is not only admissible, but it is demanded. Such is 
the daily experience of physicians the world over. If, 
therefore, the patient is prostrated ; has a feeble pulse, 

* When the stomach is irritable minute doses of concentrated 
food, for example, a teaspoonful of beef essence, repeated every 
fifteen minutes, will produce quiet and sleep. 



HOW TO DEAL WITH INEBKIATES. 157 

a cold and clammy skin, a trembling tongue, and hurried 
breathing, the indication for the use of alcohol is clear 
and positive. The indications to cease its administra- 
tion are, a return of warmth to the surface, the ability 
to retain and appropriate food, and a steady heart. 
Then total abstinence is as imperative, as was its oppo- 
site in other conditions. One fact I have noticed after 
years of close observation with all forms of alcoholism, 
which I desire to emphasize: I never saw delirium 
tremens supervene under the gradual diminution of alco- 
holic beverages, and never had occasion for padded room 
or physical restraint, in delirium tremens under the 
alcoholic treatment. Delirium tremens often occurs as 
the result of shock to the nerve centres, by the sudden 
and immediate abstraction of all stimuli, as is observed 
in prisons and hospitals w T hose practice favor that plan, 
but by the gradual removal of accustomed stimuli to 
avoid shock, never, in ray observation. 

In the discussion of treatment, so far, we have not 
gone outside the home, and in reviewing what has been 
written, it may be concisely stated thus. Alcoholic in- 
toxication is a neurosis, which must be placed under the 
care of the family physician, and dealt with on the 
same principles as other disorders of the same class. 
The hospital or asylum treatment will be considered in 
another section. 



158 ALCOHOLIC INEBRIETY. 

DIFFERENT ALCOHOLS AND THEIR 
EFFECTS. 

The opinion that alcohol, being a poison, should not 
therefore be used in the treatment of poisoning by its 
use, is commonly accepted as a truism, and bears upon 
its face the appearance of fairness, and reasonable argu- 
ment. I shall devote a few moments to the considera- 
tion of alcohols, and I, think, demonstrate the fallacy of 
the popular opinion. 

Modern chemistry has discovered no less than half a 
dozen varieties of alcohols, that are considered as im- 
portant, each differing from the others in its atomic com- 
position, and varying to some extent in results. 

Modern pathology, too, has traced striking differences 
in the effects of these different varieties. So that we are 
not always certain whether the symptoms we observe, 
are the result simply of alcoholic poison, or of some of 
the new properties of alcohol, which disclose themselves 
in the various changes the drug undergoes after it enters 
the stomach. 

In France a decided difference has been observed 
between the symptoms of the alcoholism of the country 
peasant, and that of the city workman, which difference 
is attributed to the difference in the properties of the 
alcohols consumed. 

We are indebted also to Dr. T. L. Wright, of Belle- 
fontaine, Ohio, for valuable observations on the different 
effects, not only of different alcohols, but of the same 
drug in its primary and its secondary results upon the 



DIFFERENT ALCOHOLS AND THEIR EFFECTS. 159 

same individual, which observations have great practical 
value. " When the operation of the stimulant is recent/' 
says Dr. Wright, and it acts upon the " unchanged 
nervous system/' the impression is quite different from 
what it is when the chemical effects of alcohol begin to 
declare themselves — these chemical changes being the 
elimination of other poisons, such as "carbonic acid and 
urea/' which, entering the blood, reach the brain, espe- 
cially at the end of a prolonged and profound debauch, 
when there is a complete change in the symptoms. In 
the beginning of a debauch the unchanged alcohol 
produces its specific effects, with which all are familiar, 
such as an exhilaration of the natural qualities of the 
subject of its use, exhibiting traits of character which are 
recognized as belonging to his individuality, etc., but 
continuing its use, as new qualities are set free, they 
invade the brain, until the whole nature seems to be 
changed, and as Dr. Wright forcibly expresses it, these 
natural traits and exhibitions of character are "lost and 
overborne by the tremendous and universal oppression 
of a new group of poisons, differing totally in their 
effects from alcohol." This " new group of poisons " is 
wrought out of the vital laboratory, in which are 
produced "chemical reactions of alcohol" which usurp 
the place of the original poison, and produce such 
changes of tissue and function, as are quite different from 
the effects of the drug before it has undergone chemical 
change, and thus eliminated additional forces, the effects 
of which vary. 

M. Rabuteau, of Paris, demonstrates, in his "Ele- 



160 ALCOHOLIC INEBRIETY. 

ments de Pathologie," that alcohols are dangerous in 
proportion to the complexity of their atomic composition, 
and recent experiments upon animals have shown that 
certain varieties of alcohol, will not produce convulsions, 
for example, while others will, and that the effects on 
man should be studied with reference to this, and other 
newly discovered facts. 

In a paper recently read by Professor Verga, before 
the Lombardy Institute of Science and Letters — 

"He pointed out that the abuse of spirits is much 
more injurious than the abuse of wine, and related the 
case of a brandy manufacturer who, through the inhala- 
tion of the alcoholic fumes, in which he was obliged to 
spend much of his time, fell ill, and died of alcoholism, in 
a lunatic asylum. A distinction, too, should be drawn 
between old spirits and new spirits; between that 
obtained by distillation from wine and that obtained 
from grain. " 

In Germany a curious fact has recently been noticed : 
that symptoms of sleeplessness, excitement and delirium/ 
resembling some forms of inebriety, are developed by the 
consumption of diseased potatoes and sausages. So 
close is the resemblance that the terms potato and 
sausage intoxication are applied to these symptoms, thus 
demonstrating that the blood contaminated by such 
poisons may derange the brain in like manner with 
alcohol, producing similar symptoms of intoxication.* 

Dr. J. Milner Fothergill, of London, has shown that 
certain foods which are taken with apparent impunity 
* British Medical Journal, Dec. 30, 1882. 



DIFFERENT ALCOHOLS AND THEIR EFFECTS. 161 

into the stomach, really make no morbid impression 
during primary digestion, but during the stage of diges- 
tion when new products (poisons) are eliminated, which, 
entering the circulation, and lodging in the brain, dis- 
close symptoms of mental alienation. This cannot be 
from the food in its original forms ; but from the disin- 
tegration of its atomic qualities, and the chemical re- 
actions consequent upon such process, new poisons are 
eliminated, and bring about symptoms of insanity or 
inebriation. 

So, also, the accomplished Dr. Eaynor, of the Han well 
Asylum, in England, confirms these views. He laid 
before the International Medical Congress, in Lon- 
don, 1881, a paper on " Gouty Insanity," showing that 
the poison of gout produces similar symptoms, which 
vary in degree, in proportion to the intensity of the 
poison. He shows that when the poison is not intense, 
it results simply in sensory hallucinations or melancholy. 
When it is " intense and sudden" the result is mania or 
epilepsy. When " intense and protracted" the usual 
result is general paralysis, and when attacking a person 
broken down by alcoholism or lead-poisoning, the result 
is " varying degrees of dementia." 

Dr. Robert Grieve, of the Colonial Lunatic Asylum 
at Berbice, adds his testimony in the same direction, by 
affirming that "of the Coolie patients in that Institu- 
tion, a very large proportion owe their mental troubles 
to the abuse of Cannabis Indica, or bang, and only a 
very few to alcoholic excess." * 

* British Medical Journal^ Dec. 30, 1882. 



162 ALCOHOLIC INEBEIETY. 

These are curious and interesting facts, and go to show 
how little we have known in the past, about the effect of 
alcohol upon the brain, and to open the door to much 
grander fields of research. We have learned this much, 
that the violent and abusive behavior of the drunkard, 
toward those especially whom he should love and cherish, 
is due to a change of cerebral function, which depends 
upon one or more of the "new group of poisons," 
described by Dr. Wright, who says, " There is a reason 
for this conduct quite different from the inborn wicked- 
ness to which it is usually ascribed." 

These new poisons have called forth from the 
brain, passions that have been concealed or subdued, or 
originated by metamorphic change, and forced them 
into extravagant and violent forms of expression. 

In the medical treatment of these cases, some of the 
symptoms of which are very similar, there should be no 
room for much divergence of opinion. If we have 
great feebleness and depression, feeble and rapid pulse, 
muscular tremor, cold and clammy skin, soft and tremu- 
lous tongue, with perhaps hallucinations of one or 
more of the senses, we want to bridge over a serious 
crisis, to save life long enough, to secure the acceptance 
of food, and other supporting treatment. We know 
that alcohol has been indicated in such 'cases for cen- 
turies ; we know, in our own experience, that it has 
carried our patients over many a dangerous crisis, and 
we have no cause to stop and speculate as to the poison 
which has produced this condition. We know that 
alcohol will steady the heart, slow the pulse, warm the 



THE PSYCHOLOGY OF INEBRIETY. 163 

skin, and calm excitement, and we ought to use it. We 
should also know when to stop using it, and when to 
insist upon total abstinence from all intoxicants forever. 

THE PSYCHOLOGY OF INEBRIETY. 

Psychology has much to do with inebriety, not only 
as to its history, but as to its management. The caree'r 
of an inebriate is distinguished by remarkable psychic 
exhibitions, which, if not understood, often lead to 
misapprehension and mismanagement. Though inebriety 
is a physical disease, it is nevertheless clearly identified 
with psychical phenomena, the study of which tends to 
a clearer apprehension of mental states. If we have a 
sensory or psychological effect, following any given 
state, or if we have a physical condition, that can be 
traced directly to sensory or psychical causes, we have 
a matter of great interest, which we cannot afford to 
overlook. 

Reference has been made to "psychical traumatism," as 
an exciting cause of paroxsyms of inebriety. Such a 
term includes what many persons call mental shock, as 
sudden alarm, profound grief or sorrow, and surprise in 
a variety of forms ; but there is a kind of physical 
impression, that is not shock nor surprise, neither grief 
nor joy, that may be often observed. 

The bodily force of an habitual toper is, of course, 
weakened by his mode of life, and with it the mental 
functions share in a degree, either of feebleness, or of a 
departure from their normal parallelism with healthy 



164 ALCOHOLIC INEBRIETY. 

organic life. It may not be the feebleness of dementia, 
such as so often attends paralysis, but it shows itself in 
waywardness, in a want of fixity, and a lack of power 
to co5rdinate itself with natural functions in other parts. 

It may be that there is a sluggishness in all the 
activities of the being. Not so much a dullness of 
comprehension, perhaps, as a slowness to respond to 
suggestions, or appeals, which would be spontaneous and 
instinctive, if there was no disturbance of correlative 
forces. There can be no enthusiasm in such a condition. 
But let such a sluggishness be temporarily aroused, 
re-awakened, even by an artificial stimulant, and whether 
it be an arousement of psychical energy, whicfi is trans- 
mitted to the consciousness or representation, or by a 
combination of other forces or qualities, the fact is still 
apparent, and is vivid with instruction. 

Nothing is more common in the career of the inebriate 
class, in connection with psychical manifestations, than 
for them to recall, and relate, facts and incidents, 
while under the exhilarating influences of alcoholic 
beverages, that have lain dormant, and been forgotten 
beneath the heap of benumbed qualities, that are the 
product of alcoholic indulgence. 

It is thus that men of this class so frequently, when 
in company with each other, as the intoxicating cup 
passes from lip to lip, and the tide begins to rise, find 
themselves revealing the background of life's picture, and 
bringing out qualities, and figures, that they usually desire 
to conceal. And thus, too, that after the period of 
exhilaration shall have passed, and they fall back upon 



THE PSYCHOLOGY OF INEBRIETY. 165 

the barren heap of their own depleted and exhausted 
energies, there shall be no vivid recollection of the 
descriptions they have given. What that background 
may be, what facts and figures it may reveal, of course, 
depends upon the temperament, taste and training of each 
individual. 

For example. A group of such men, who have had 
a sound religious training, of similar social positions and 
associations, but who have been led into excess, and its 
accompanying evils, sit down together, for a game of 
some kind. The bottle is passed from one to another, 
and the whole circle presently feels the glow of excite- 
ment, which is arousing the dormant faculties of each ; 
the memory is stimulated, and one of the party announces 
that, in his opinion, this game is wrong, and should not be 
continued. With this announcement, he repeats the 
instructions of his early life, and brings forward the 
counsels of those who have guided him. The others do 
the same, the game is laid aside, for the time, and a 
discussion is commenced. It would surprise many a 
stalwart temperance advocate, to listen to the theological 
disquisitions which flow from the lips of such a group, 
and how, one by one, they bring out the figures of the 
past, and array them appropriately on the face of the 
mental canvas, that they are exhibiting. Like an old 
painting with wrinkled canvas, faded outlines, and figures 
indistinct, when subjected to the fresh touch of the artist, 
his brush removes the cloudy surface, restores the figures, 
and brings out the whole in plain relief, that it may be 
examined and appreciated. It may not seem appropri- 



166 ALCOHOLIC INEBRIETY. 

ate to give to the bottle, the attributes of the artist, but 
the illustration is by no means overdrawn. Whatever 
may be the deepest, and perhaps the remotest impression, 
or th§ latent quality of the mind, that belongs to its 
nature, or the accumulated gifts of culture or taste, they 
may all be obscured and hidden, behind the tarnish of 
time or abuse; but when the adventitious gloom is 
removed, the original, though it maybe stained, and even 
torn, stands out, true to itself, and to its grouping with 
others. The subjects are various ; Science, Politics, or 
any other, that may have had the most prominent place 
in the mind in times of sober living. The period is 
reached, however, in due course, when the state of mere 
elation or exhilaration, gives w^ay to stimulation, by the 
continued use of the bottle ; when the outlines of the 
reproduced figures become blurred again, and confused 
conversation takes the place of that which was clear and 
deliberate • the quiet discussion ceases, and a boisterous, 
perhaps a tragic end, may terminate the interview. The 
pleasing glow of excitement, resulting from the moderate ' 
use of the bottle, is lost by the stimulating effect of its 
contents, and the fresh and enjoyable reminiscences of 
the past, thatcheered and enlivened their social intercourse, 
is lost in the extravagant and senseless jargon of the 
debauchee. 

The lessons to be learned by these experiences, are 
instructive to those who have to do with inebriates, or to 
those who desire earnestly and honestly to study them. 

I cannot well forbear the introduction at this point of 
a case, to illustrate the psychical condition, which attaches 



THE PSYCHOLOGY OF INEBRIETY. 167 

to some cases that are not traumatic, and yet at the same 
time are impressive, as facts. 

Soon after taking my seat in a street car, in Philadel- 
phia, about two years ago, a young man entered, but in 
a few moments changed his place, to a vacant seat at my 
side. As he did so, he mentioned my name, and 
presented. before me, an envelope with his own address 
upon it, which I at once recognized, and greeted him 
accordingly. He w r as a former inebriate patient, whom 
I had not seen for eight years, or more. He was able to 
say- that he had not tasted alcoholic liquors during that 
period ; but he wished to narrate certain experiences that 
he had encountered during those years. He said, "I do 
not find it so hard to abstain from drink, as I do to 
avoid the conditions and circumstances which lead to 
drinking." Meeting with certain people, passing or 
frequenting certain places, and doing things without 
drinking, that he always used to do while drinking, was 
the hardest struggle of all. To be invited to drink by 
a stranger, or in a new place, w r as no inducement to 
indulge. 

He narrated the following, toconfirm his statement: — 
He and a few comrades were in the habit, at a given 
hour in the morning, during the summer months, of 
visiting a certain saloon, where they partook of a fancy 
drink of rare attractions, the bartender being regarded 
as ah expert in its manufacture. He said, u I seldom 
think of the place now, unless I happen upon it in my 
drives about the city, or meet with one of my old com- 
panions, during the hot months; but if the time and 



168 ALCOHOLIC INEBRIETY. 

conditions are suitable, and I come within sight of it, 
instantly the figure of the expert barkeeper, the crackling 
ice, the cooling beverage, and the familiar forms and 
voices of my old friends, come vividly before me as a 
living picture, and I seem to be one of the old party. The 
impulse to enter is almost overpowering. The only thing 
I can do, (and I am thankful that I do it instinctively) is 
to put whip to my horse and drive away, at a rapid gait. 
Lest I may meet some of my friends on their accustomed 
route, I hasten toward the streets that are out of their 
familiar course. 

The picture follows and haunts me, however, till I 
am in the Park, or out of the neighborhood, or at my 
stable. In this case, there was no traumatic shock, in 
the true sense, no sudden grief, or sorrow, or alarm, to 
throw him off his balance, nothing even to entice the 
old passion, but the simple association of thoughts and 
memories, clustered about a place, and a few persons, at 
a particular hour in the day, at a particular season of the 
year, producing a psychical impression, as difficult to" 
overcome, as the group of traumatic effects described by 
Crothers and others. 

Again. During his years of indulgence, there was a 
certain day, memorable as an anniversary of some special 
event, on which he opened for the first time a bottle of 
wine at dinner, of rare quality. After abandoning 
his drinking habits, at one of these anniversary days, 
which were still celebrated, he was suddenly impressed, 
while at the dinner table, with the thought, that the 
occasion would not be complete without the presence of 



THE PSYCHOLOGY OF INEBRIETY. 169 

that particular brand of wine, and proposed to his wife 
to send out and get a bottle. 

She recognized, at once, the coincidence between the 
special day, and the special brand, and such an unex- 
pected, and for the moment, alarming proposition, and 
as they looked at each other earnestly, he recalled, 
the proposition. But the recollection of the wine 
having been used, in commemoration of an event that 
he did not wish to cease celebrating, lingered in the 
mind, and tarried long enough to annoy him, and awaken 
a train of phenomena, which were symptomatic of nerve 
disturbance, to a degree to develop the prodromic signs 
of an invasion of the old disease. For several days, at 
the five o'clock dinner, these nervous symptoms w r ere 
repeated, and nothing but a change of the hour to six, 
and going to bed soon after, for several consecutive 
evenings, allayed the irritability, and enabled him to 
recover his wonted steadiness of nerve ; there was no 
longing for liquor, as in the chronic toper, no gastric 
yearning or sense of physical need. It was simply the 
association of thoughts and memories, in connection with 
an event which had not been completed by the omission 
of a conspicuous feature of the social entertainment, which 
on previous occasions, had been regarded as important, 
if not essential. No doubt that if the bottle had been 
presented^ as a completion of the outfit, his will would 
have been captured, and he, overpowered. 

So had the eight years been spent, since he had 
abandoned a life of excess. A young, active, prosperous 
business man, in daily conflict with a constitution, that 
12 



170 ALCOHOLIC INEBRIETY. 

is signalized by a remarkable appetency to psychical 
manifestations. 

Such protracted conflicts, when victorious, are deserv- 
ing of honorable record, and when followed by defeat, 
should not be remembered with reproach, or condemned 
as types of unworthy manhood. 

But few persons pause to think of the inner movings 
and impulses, the secret forebodings, of those who come 
into the world weighted with psychotic conditions, that 
predispose them continually to disaster and failure, and 
but few, who find themselves on an even plane of life, 
without such marked predispositions, are able to com- 
prehend, much less to judge, their fellows. 

In the case of this young man, as in other cases of 
excess, there were certain molecular changes which had 
been going on during the stage of his life that was 
given to dissipation, of which he was unconscious, that 
were imperceptibly laying the foundation for future 
functional disorder, and perhaps organic change, that 
magnified and intensified his proneness to morbid feeling 
and pursuit. While apparently healthy, and able to 
conduct a responsible business, it is at the expense of a 
constant strain, w T hich in its turn, draws largely on the 
stock of psychical energy, that, together with the ex- 
penditure of physical strength, is calculated to keep him 
in a state of uncertainty,— all the time on the alert, living 
a life of intensity, and but for the remarkably developed 
capacity, either to adapt himself to new conditions, or 
promptly to evade or escape thera, not by resistance, 



THE PSYCHOLOGY OF INEBKIETY. 171 

but by seeking adverse avenues or outlets, he would 
have been a wreck before now. 

Had he fallen in with his former companions, and 
joined them at the bar of the saloon, it would have been 
impossible for him to have escaped indulgence, and its 
consequences — a debauch ; his will would not have 
held the supremacy; but by adroitly averting the im- 
pending risk, he was safe. So with the bottle at dinner. 
Had he placed himself face to face with it, and attempted 
to antagonize its use, by his will-effort merely, he would 
have yielded, been debauched, and awakened from it, to 
combat life again, possibly, with an added lesion, either 
of function or structure, fastened upon some portion of 
his complex organism, thus increasing his inability to 
resist or evade future attacks. 

He did not drink, because he was able to disconnect 
the chain of circumstances and associations formerly con- 
nected with the act. Had he caused them to unite, and 
thus made the links consecutive in his mind, it would have 
seemed to him necessary to drink. There are many men 
who scarcely think of drinking, aside from the associated 
facts and conditions, which are, as it were, cartooned in 
striking outline before their mental vision, and if the 
picture is not complete, if the central figure in all circles 
and associations of drinking men — the bottle — is not 
present to the mental vision, there is not much risk. 
The bottle is the pivot on which everything turns, and 
around which everything revolves. Repudiated, as it 
should be, as essential to any civilization, it continues to 
hold its conspicuous position, and challenges the interest 



172 ALCOHOLIC INEBRIETY. 

of its devotees to a degree, that efforts to restore them to 
society and themselves are utterly fruitless, while it 
continues to hold its supreme attitude, in relation to their 
lives. 

As association has much to do with continuing a habit, 
so change of association, has much to do with a change 
of habit; and as habit so often depends upon abnormal 
states of the physical system, so avoidance of habit, 
will frequently relieve the organs of the body 
from service that is constantly demanded, by its morbid 
conditions, which are symptomatic of disease. Hence 
the advantage of change of residence for a time, to get 
beyond the voice and influence of familiar associations. 
Among new places, and new faces, new impulses begin to 
throb, new thoughts to form, new remedies to be 
employed, and a new life to begin, with new experiences 
to strengthen its beginning, until a new constitution and 
a new character, demonstrate that transplanting to a 
new soil, is the first movement towards harvesting new t 
fruit. 

Such transplanting is, however, impracticable, in the 
majority of cases, unless, indeed, the Government should 
discover that it is the duty of the State, to protect and 
restore such cases, as she does her insane, her blind, her 
mutes, and as she does, in another manner, her wayward 
and criminal classes. 

When the people shall learn that insanity, idiocy, 
epilepsy, inebriety, and, to a great degree, crime, all 
belong to the same family, and all grow in the same 
soil, then will provision be made alike for each. 



THE PSYCHOLOGY OF INEBRIETY. 173 

But there is no class of citizens in the Commonwealth 
more isolated from the guidance and protection of 
law, from the fostering influence of domestic and social 
attachments, from the relief that comes from a share in 
the common bond that unites men, in the relation of 
fraternity, and from the church and her appliances, than 
the inebriate class. This is not surprising, however, 
because there is no form of humanity more loathsome, 
than that which is disfigured, and spoiled by the toxic 
power of alcohol. Hence, as a class, they are drawn 
towards each other by affinities, that are common and 
peculiar to themselves. Having no union of tastes or 
tendencies, with the multitude of men, who crowd the 
same road way. of life, they diverge into paths distinct- 
ively their own. In consequence, too, this very separa- 
tion from others, and this natural grouping together of 
themselves, in their own morbid ways, causes them to 
move along with more friction, than other classes of 
men. And hence they become the victims of each 
other's cupidity and deceit, and their pilgrimage is hard 
and full of misery to themselves, and a source of suffering, 
distrust, fear and expense to society. 

The illustrations already offered, exhibit the operation 
of psychic force upon bodily functions, or the reverse. 
In the class of persons we are dealing with, there are 
numerous and constantly occurring phenomena of this 
character, which have much to do in guiding the treatment, 
but they will not be available for practical application, 
until this whole subject is withdrawn from the domain 
of morals, as the starting point of investigation and 



174 ALCOHOLIC INEBRIETY. 

discussion. The soil in which it is seeded, and where it 
takes root, is in the realm we have been traversing, in 
which the moral aspect is simply a secondary correlative. 
At this point, the natural enquiry is for the evidences of 
physical disease, seeing that throughout this narrative, 
there seems to be no period, when the craving or passion 
for drink was prominent. In answer, it may be said, 
referring to the case noted, that after eight years of sober 
and industrious living, with the discipline and culture 
of such living, the attitude of the man's thoughts and 
feelings, in their relation to his previous dissipations, 
was entirely changed, and his approaches toward them 
were necessarily in the order of his reversed thoughts. The 
tendency, however, the predisposition, the susceptibility 
which constituted the pre-existing abnormal condition, 
though latent and remote, was still there, and it was the 
struggle to reinstate the old order of things, and to bring 
out the latent morbid element, and give it the dominant 
position in his case, that caused the train of nervous 
symptoms to be set up, which threatened to overcome 
and prostrate him. 

Morbid psychology embraces an almost limitless roll 
of, as yet, nameless phenomena, which will, in time, 
naturally group themselves into classes, and take their 
places as symptoms of abnormal conditions, which are 
now only recognized as eccentricities, and peculiarities, 
that appear rather as accidents of character, than as the 
legitimate results of pathological states. 

Psychological science is constantly unfolding secrets, 
that have been hidden by the ignorance of the past, and 



THE PSYCHOLOGY OF INEBRIETY. 175 

especially in the field we are now exploring. Witness 
the illustrious services of modern psychologists, both at 
home and abroad, whose works are doing so much to 
instruct and modify public sentiment, by widening and 
deepening its scope of observation, and extending its 
capacity to know, and to judge of human conditions, and 
conduct. 

The psychcial side of the inebriate, is a most profound 
and absorbing study. It is a feature in his career which 
must be" understood, if we would rightly understand 
him. 

Elsewhere, it has been seen how mental shock has been 
the exciting cause of drunkenness. Indeed, nothing is 
more common, than for men to excuse themselves for 
drinking to excess, because of some disappointment, 
misfortune, or grief. Financial embarrassment, loss of 
friends or kindred, are conspicuous among the exciting 
causes of excess ; and in this regard there is a singular 
conformity with the causes of insanity, as laid down in 
the reports of asylums for the insane. 

It is equally true, however, that shock, fright, or other 
sudden emotion, may act as an immediate cause, or start- 
ing point of recovery. Dr. Rush mentions the story 
of several young men who became intoxicated in a 
little cabin, located on the banks of the James River, in 
Virginia, but a sudden rise in the river came on, and 
floated the cabin and its contents upon the dangerous 
current, and the peril of their situation, when they began 
to apprehend it, was so alarming to them, that they 
were entirely sobered, by the time they were driven 



176 ALCOHOLIC INEBRIETY. 

ashore. He mentions also/ on the authority of Dr. 
Witherspoon, the case of a Scotchman, who was always 
cured of a fit of drunkenness by being made angry, and 
he was always angered, by talking to him against religion. 

From my own clinical records I could narrate case 
after case, in which mental impressions had much to do 
with modifying the action of intoxicants, and in some 
instances, where prompt recovery, not only from a single 
attack, but from future excess, was induced by strong 
and sudden mental emotion. A young man of culture 
and wealth, whose opportunities in life were exceptional, 
had for years given himself to loose company and 
dissipation. Every motive had been appealed to by his 
parents, and every inducement offered, for him to make 
an effort to change his course, but without avail. One 
evening, on returning home, in a state of only moderate 
intoxication, his father directed him to go to his room, 
pack his trunk, and be ready for a start by a morning 
train, for an institution for inebriates. Looking at his 
hitherto forgiving and indulgent father, he put the 
question, "Are you in earnest?" The reply was 
prompt and decisive, u Yes, in earnest." 

The following morning found the young man at the 
breakfast table, with his mind impressed as it never 
had been before. He had met a crisis that he had not 
for a moment anticipated. He saw himself in a new 
light, even as a public inebriate, with a father whom he 
had always trifled with, but who was now stern, decided 
and inflexible. The attitude of his home, and its inmates 
was changed toward him; his own attitude in relation to 



THE PSYCHOLOGY OF INEBRIETY. 177 

them and to society was modified. A new set of impres- 
sions had established themselves in his mind, and, for 
the time, were supreme in their influence upon his 
consciousness, his judgment and his will. 

They overpowered him, and he determined to make 
an effort at self-reclamation, which was for a consider- 
able time successful. 

This sudden and unlooked-for shock, affected, not 
only his moral nature, arousing him to a consciousness of 
his relations to others, such as he had not before thought 
of, but upon it, supervened a change of physical state. 

The deepest emotions being stirred, a new power was 
felt in the whole being, and all the functions were re- 
animated, so that the man felt himself new again, and 
while the overpowering influence of the newly stimulated 
emotional nature, maintained the supremacy, so long did 
he feel secure from relapse. In the case of this young 
man there was first, a new awakening to his true condition. 
His pride was then stirred, to avoid the disrepute of a 
committed inebriate. His fear of punishment, of being 
banished from home, next asserted itself, and thus, for a 
time, his morbid passion for drink, was held in abey- 
ance. 

It is in obedience to the same law, that so many 
sudden " reformations" as they are called, appear, in 
times of great public interest and effort in this behalf, 
and for similar reasons, that such u reformations," are 
transient and unstable. The same thing is seen in other 
maladies. 

But a few months since I was called to see a young 



178 ALCOHOLIC INEBRIETY. 

lady of refined feelings and nature, who was suffering 
from an attack of acute mania. It was the third time I 
had treated her, during the last few years, for the same 
affection. She was kept at home. Her father had 
spent the last year or more of his life, in an asylum for 
the insane. She visited him during his residence there, 
was familiar with the place, and had frequently spoken 
in praise of the institution, and its management. During 
this attack, which was a little more obstinate and 
protracted than the others, I recommended to her family 
her removal to the same institution. It was mentioned 
to her, and she consented. Her family were desirous that 
it should be done. The necessary papers were executed, 
and a day fixed for her departure. 

During the preparation for her removal, her whole 
thought seemed to be absorbed with the question how 
her mother, who was in feeble health, could get on 
without her presence and assistance. This was the 
preponderating thought that occupied her mind, day and , 
night, and in trying to solve it, she was so much 
improved when the time came for her removal, that she 
accompanied her sister to my office, for the purpose of 
satisfying me, that there was no need of her going, and 
she remained at home and is now as well as usual. The 
one absorbing thought of her feeble mother was the pre- 
ponderating and controlling thought. It possessed her, 
and took the place of the morbid fancies and delusions, 
that were urging her to self-destruction. 

Such cases as these are constantly observed, and no- 
where more conspicuously than among inebriates. The 



THE PSYCHOLOGY OF INEBRIETY. 179 

shock of an accident, or of a new and sudden change of 
base, with reference to any given purpose or plan, will 
give a new direction to the life, by its effect on the ani- 
mal functions. 

No fact in physiology is better known, perhaps, than 
that organic functions may be materially modified and 
even suspended by the emotions. All the processes of 
nutrition, acted upon by the vascular and nervous 
systems through the emotional nature, are subject to 
striking modifications : and this fact should be availed 
of, in conceding the peculiarities of inebriation, as they 
are manifested in different individuals. With such 
knowledge, and the practical application of such princi- 
ples, to the treatment of inebriety, there will be much 
more hope of success than by the present popular mode 
of promises and pledges, seventy-five per cent, of which 
are, in the very nature of things, broken. 



180 ALCOHOLIC INEBRIETY 

SUMMARY. 

In concluding these pages, it may assist the reader to 
recapitulate, in a brief summary, the chief points to be 
remembered, in connection with the doctrine of disease 
as applied to alcoholic intoxication. 

1. Some persons are born with an alcoholic diathesis, 
that is to say — with an appetency for alcoholic beverages, 
and a tendency to intoxication. 

2. The desire for such stimulants is from within, its 
source and origin being independent of external tempt- 
ations. 

3. It may be prematurely evolved by a careless in- 
dulgence in intoxicating liquors, without its possessor 
being aware of its existence. 

4. It is the internal craving for alcoholic liquors, 
and for their intoxicating effect, that constitutes the 
disease, and not the fact of drunkenness. 

5. It may be produced by external injuries, especially, 
of the head, or by other sudden, alarming or depressing 
shock to the nervous system. 

6. It may manifest itself, in the form of unexpected 
paroxysms, with intervals of sobriety, and even of 
dislike for liquors. 

7. These intervals are of varied duration as to time, 
but when the paroxysms occur, no considerations of 
home, or duty, or affection, or morals, or religion can 
influence the victim to pursue a different course. 

8. The paroxysms are apt to increase in frequency 
and duration with their repetition, so that chronic 



SUMMARY. 181 

alcoholism may supervene, and end the career of the 
inebriate. 

9. Frequently there are well marked premonitory 
signs, which introduce a paroxysm of intoxication. 
Such as restlessness, irritability, general malaise, or it 
may be, the occurrence of an injury. 

10. The paroxysms may be arrested, prevented, or 
controlled, by becoming familiar with the prodromic 
symptoms, and giving timely heed to their admonitions 
by the use of remedial measures. 

11. They may terminate at a certain period of life, 
by the apparent exhaustion of the hereditary taint, at 
what is called the climacteric period. 

12. The hereditary tendency may be transmitted in a 
direct line of inebriety, or it may be deflected, and 
appear by transmutation, as epilepsy, insanity, chorea, 
hysteria, or even — crime. 

13. While there are resemblances between inebriety 
and insanity, in some of their manifestations, there are 
decided differences in their pathology, which entitle them 
to be regarded as distinct, though somewhat similar 
diseases. 

14. In some inebriates there is a state of partial un- 
consciousness during a debauch, in which they may 
commit acts of violence, and have no memory of it 
afterwards ; a state that is called cerebral automatism, 
or trance. 

15. The most successful treatment is that which 
combines with wholesome restraint, psychological and 
hygienic methods, such as are successfully employed in 
hospitals for inebriates. 



INDEX. 



A PAGE 

Artificial Nutrients 10 

Aspect, Yice 12 

Alcohol, Toxic Action of 19 

Alimentation, Disordered 46 

Appetites, New 46 

Asthenia, Nervous 52 

A Great Age 54 

Automatic Intoxication 66 

Alcoholic Dementia Ill 

Asylums for Inebriates 114 

Asylums for Insane 114 

Admissions, Number of 121 

Address, by Dr. Willard Parker 124 

Appeals, Religious 137 

Agencies, Extrinsic 140 

Acute Disease 145 

Accident 145 

Alcoholism ' 152-158 

Acute Intoxication 154 

Alcoholic Treatment 156 

Alcohols, Different 158 

Alcohol, Chemical Effects of 159 

Abstinence, Total 163 

Acute Mania 178 



Bulimia 47 

Border-land Cases 50 

Bible Stealers 62 

Bone, Necrosis of 69 

Brothers, Two 96 

Business Interest 137 

Background of Life 164 

C 

Craving for Drink 10, 14, 45, 51, 56, 70, 

72, 79 

Curable Disease 11 

Change of Character 14, 41 

Changed Men 16 

Consciousness, Self 19, 137 

Crime-view 24 

Crime-cause 28 

Crime and Disease 37 

Cerebral Injury 44 

Chlorosis 45 

Chthonophagia 48 

Concuss! n 68 

Consumption, Pulmonary 69 

Cerebral Disease 70 

Children, Tendency to Drink in 71 



PAGE 

Chorea 76 

Climacteric Period 80 

Childhood Craving 80 

Cures, Permanent 121 

Corrective Institutions 123 

Constitutional Tendency 135 . 

Co-operation of Patients 1*0 

Change of Standpoint 140 

Chance at Him 153 

Cannabis Indica 161 

Change of Residence 172 

Class, Isolated 173 



Disease, Curable 11 

Disease and Yice..... 13 

Drunkenness, Normal 14 

Dyspeptics 18 

Drunkenness, Vice of 23 

Drunkenness, Causes of 11, 34 

Disease and Crime 37 

Disorder, Nervous 44 

Dirt Eating 47 

Disease, Gastric 47 

Delusions 49 

Drinkers, Saturday 60 

Drinkers, Economical 60 

Drinkers, Wasteful 60 

Drinkers on Holidays 60 

Dipsomania .• 23, 41, 68, 70, 72, 111 

Disease, Cerebral 70 

Drunkenness, Longing for 91 

Debauch, Preventing a...., 146 

Departure, New 146 

Drunkard, Habitual 149 

Delirium Tremens 155-157 

Different Alcohols 158 

Duty of the State 172 



Evenly Balanced People 10 

Eating Dirt 47 

Economical Drinkers 60 

Epilepsy 69 

Environment 76 

External Relations 90 

Egoist 137 

Extrinsic Agencies 140 

Enfeebled Will 149 

Emotion. Sudden. 176 



183 



184 



INDEX. 



F PAGE 

Foods and Medicines 10 

Forgery 26 

Food, Unnatural 47 

Fractures 68 

Factitious Heredity 79 

Fever, Typhoid 90 

G 

Gluttony 14, 47 

Gout and Insanity..... 21 

Gastric Disease 47 

Gospel Temperance Meetings 66 

Grief, Profound 145 

H 

Hereditary Taint 10 

Hysteria 45 

Head Injuries 44, 67, 68, 69 

Hallucinations 49 

Holiday Drinkers 60 

Horse Stealing 63 

Hernias 69 

Hereditary Inebriates 75 

Heredity/Factitious 79 

Homes for Inebriates 126 

Hygienic Laws 141 

I 

Inebriates, Who are? 9 

Inebriety, Remote Causes of 11 

Intemperance as a Vice 19 

Insanityand Gout 21 

Intemperance — Vice and Disease 24 

Inebriety, Disease of 40 

Inebriety, Pathology of 41 

Injury, Cerebral 44 

Inebriety, Psychical , 49 

Inebriates, Midnight..... 52, 56 

Impulse, Irresistible....! 25, 87 

Idiocy 47, 85, 86 

Injuries of Head 44, 67, 68, 69 

Inebriates, Solitary 52, 57 

Inebriety, Traumatic 69 

Insanity 69 

Imperious Impulse 71 

Inebriates, Hereditary 79 

Insanity and Inebriety, How Related? 88 

Insanity, Pathology of 89 

Inebriety, Causes of 92 

Inebriates not Insane 108 

Infirmary at Marylebone 113 

Insane Asylums 114 

Inebriate Asylums 114 

Institutions, Corrective 123 

Inebriates' View 130 

Inebriates, How to Deal with 139 

Intoxication, Potato 160 

Intoxication, Sausage 160 

Inebriety, Psychologv of 163 

Isolated^ Class 173 



L/ PAGE 

Legal Question 11 

Longing in Pregnancy 46 

Literary Men 53 

Loss of Memory 55 

Law, The 89 

Longing for Drunkenness 91 

Lawyers, Two Young 97 

Laws, Hygienic 141 

M 

Medicine and Foods 10 

Moral Question 11 

Morbid Craving 14 

Mental Condition, New 18 

Manslaughter 27 

Maryland Penitentiary 31 

Margaret Mitchell 35 

Mental Shock 41 

Midnight Inebriates 52 

Men, Literary 53 

Memory, Loss of. 55 

Meetings, Gospel Temperance 66 

Mental Unsoundness , 90 

Morbid Propensity, Victim of. 93 

Mania-a-potu 110-112 

Monomania of Suspicion Ill 

Marylebone Infirmary 113 

Motive, Overpowering -. 137 

Methods, Prophylactic 139 

N 

Normal Drunkenness 14 

New Mental Condition 18 

Nervousness 25 

Nervous Disorder..... 41 

Neurasthenia 52 

Necrosis of Bone 69 

New Departure 146 

O 

Orators 53 

Ostracism, Social 134 

Overpowering Motive 137 

P 

People, Evenly Balanced 10 

Penitentiary of Eastern Penna 30 

Prison, State, of New Jersey 31 

Penitentiary of Maryland 31 

Penitentiary of Chester, 111 32 

Pauperism 33 

Poison Acting on Blood 34 

Pathology of Inebriety 41 

Pregnancy, Longing in 46 

Polyphagia 47 

Psychical Inebriety 49 

Paralysis 54 

Pledges 66, 67 

Pulmonary Consumption , 69 



IXDEX. 



185 



PAGE 

Pathology of Insanity — 89 

Powerless Will 93 

Propensity, Morbid 93 

Punishments and Rewards 94 

Patients, Voluntary 121 

Permanent Cures 121 

Parker's Dr., Address 124 

Prophylactic Methods 139 

Patient, Co-operation of 140 

Profound Grief 145 

Psychical Traumatism 145 

Preventing Debauch 146 

Prodromic Symptoms 148 

Psychical Treatment 156 

Potatoes, Intoxication 160 

Psychical Impression 168 

Psychic Forces 173 

Psychology, Morbid 174 

Q 

Question, Legal 11 

Question, Moral 11 

R 

Revenue 11 

Repeaters 35 

Recommitments : 36 

Rewards and Punishments 94 

Resolutions of Superintendents 120 

Reformatories 126 

Residence, Change of... 172 

Reformations 177 

S 

Self-consciousness 19, 137 

Stomach 43 

Shock, Mental 44 

Solitary Inebriates 52 

Special Vices 60 

Special Forms of Violence 60 

Saturday Drinkers 60 

Smashers, Window 62 

Stealers, Bible 62 

Spade Stealers 63 

Shawl " 63 

Shoe " 63 

13 



PAGE 

Stealers, Tub 63 

Stealing, Horse 64, 74 

State of Trance 63, 73 

Stricture 68 

Shot Wounds 69 

Sentimentalism 105 

Suspicion, Monomania of. Ill 

Superintendents' Resolutions 120 

Social Ostracism 134 

Standpoint, Change of 140 

Sunstroke 144 

Symptoms, Prodromic 148 

Sausage Intoxication 160 

State, Duty of 172 

Sudden Emotion 176 

Sudden Shock 177 

T 

Toxic Action of Alcohol 19 

Temperance Meetings 66 

Tapeworm 68 

Traumatic Inebriety 69 

Typhoid Fever 90 

Thirst for Water 92 

U 

Unnatural Food... 47 

Unsoundness, Mental 90 

V 

Vice of Drunkenness 23 

View, Crime 24 

Vagrancy 33 

Vices, Special 60 

Violence, Forms of 60 

Victims of Morbid Propensity 93 

Voluntary Patients 121 

W 

Worm, Tape 68 

Wounds, Shot 69 

Water, Thirst for 92 

Will, Powerless 93 

Will, Enfeebled 149 




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I. Hearing and How to Keep It. With illustrations. By 
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44 The series of American Health Primers (now entirely completed) 
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44 Brain Work and Overwork, by Dr. H. C. Wood, Clinical Professor of 
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44 An unexceptional household library."— Boston Journal of Chemistry. 

44 Everv family should have the entire series ; and every man, woman, 
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44 Everybody knows that it is uncomfortable to be cold, but few know that 
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44 The whole series is a particularly useful one. and should be added to 
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LONG LIFE. The Art of Prolonging Life. By C. W. Hnfe- 
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ALCOHOL AND TOBACCO. Alcohol; its Place and Power. 
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THE MENTAL CULTURE AND TRAINING OF CHIL- 
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ON INDIGESTION. Indigestion : What It Is ; What It Leads 
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11 Indigestion, pure and simple, is responsible for almost all the other dis- 
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HOW TO LIVE. 

A GUIDE TO HEALTH AND HEALTHY HOMES. 
By GEORGE WILSON, M.D. Second Edition. Edited by Joseph G. Richardson, 

Professor of Hygiene University of Pennsylvania. 
314 Pages. Price, cloth, $1.00; Paper coyers, 75 Cents. 

SCOPE OF THE WORK. 

The object of the author in writing this book is to advance the art of 
preserving health; that is, of obtaining the most perfect action of body 
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Chapter I is a general introduction to the whole subject, giving a few 
statistics in regard to death rates, and remarks showing the great number 
of preventable diseases and the possibility of reducing the many early 
deaths by a proper regard of simple health rules Chapter II is expl na- 
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Only an outline of the scope of this book can be had from these few gen- 
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PRESS NOTICES. 

44 The book aims at the prevention of Disease. It abounds in sensible 
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44 Full of good sense and sound advice."— Educational Weekly. 

44 Deserves wide and general circulation."— Chicago Tribune. 



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SLIGHT AILMENTS: 

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By LIONEL S. BEALE, M.D. 

Second Edition, Revised and Enlarged. 

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